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Information about Depression
September 17, 2003
2:11 pm
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Ladeska
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Child Psychology

Child-Friendly Therapy: Biopsychosocial Innovations for Children and Families by Marcia B. Stern (W.W. Norton) A creative family-centered treatment for use by mental health clinicians who work with children. Psychologist and family therapist Marcia Stern presents a playful and creative therapy for today's kids. Her family-based treatment employs multi-sensory skill building activities, and concerns itself with taking therapy outside the consulting room. Especially valuable for practitioners when the referral problem has biological underpinnings. Today's kids are often computer literate even before they can read. They thrive on continuous visual stimulation and constant activity. They may enter treatment diagnosed with learning differences and cognitive variations that affect language, attention, and concentration. When they need help it may be hard to engage them in traditional language‑based therapy, which relies on explanation, analytic skill, and interpretation. Finding a therapy that "fits" is not easy.

Now Marcia Stern presents a new, inventive, and exciting treatment for today's kids. The book begins with an overview of child‑friendly therapy, and discusses brain­based disorders, the multifaceted approach, the biopsychosocial framework, and the role of the family as central to treatment. The general guidelines of the therapy are presented with an emphasis on the collabo­rative and resource‑oriented nature of the work. The second part of the book focuses on assessment. Stern reminds the clinician to "keep the brain in mind." She offers easily digestible "brain basics" and provides helpful ways to use this information in treatment, together with suggestions for how to talk to children and families about the way the brain works. Completing the second part are two chapters detailing the assessment of individual, family, and school contexts.

The book's final section provides readers with a thorough discussion of treatment in action, and elaborates on Stern's conviction that successful therapy is therapy that is sent home with the family. In‑depth case examples, exercises, and descriptions of action‑oriented techniques, make therapy sessions come alive for readers. Chapters on working with groups and on termination round out the book and detailed appendices, containing over 50 pages of materials, games, and resources, make this an all‑in-­one package for the clinician.

Child-Friendly Therapy helps clinicians help family members work as a team, strate­gizing and collaborating with the therapist in a systemically informed treatment. Essential reading for everyone working with today's kids, this book is a rewarding and highly informative tour through cutting‑edge therapy for children and their families.

Children of Depressed Parents: Mechanisms of Risk and Implications for Treatment edited by Sherryl H. Goodman, Ian H. Gotlib (American Psychological Association) Depression is among the most common psychiatric disorders in adults. Rates of depression are higher in women than in men: One in 5 women and 1 in 10 men can expect to develop a clinically significant episode of depression at some point in their lives. Depression is also a highly recurrent disorder: Over 80% of depressed individuals have more than one depressive episode. In fact, more than 50% of depressed individuals have been found to relapse within 2 years of recovery; individuals with three or more previous episodes of depression may have a relapse rate as high as 40% within only 12 to 15 weeks after recovery. Moreover, data suggest that individuals who have experienced a depressive episode do not return to completely asymptomatic functioning following the episode, but rather, continue to experience subclinical levels of depressive symptoms. Finally, depression may be particularly prevalent during women's childbearing years and among women with young children. These data converge to suggest that a large number of young children are exposed repeatedly to maternal depression and consistently to subclinical depressive. There is little question that this exposure has adverse consequences.

We should be concerned about the functioning of children of depressed parents for a number of reasons. First, depression is highly heritable. Second, infants born to mothers who are depressed during pregnancy may be exposed to neuroendocrine abnormalities, reduced blood flow to the fetus, poor health behaviors, or antidepressant medications. Third, many of the symptoms of depression are incompatible with, or preclude, good parenting. Thus, feeling sad or blue, experiencing loss of interest or pleasure in one's usual pursuits, loss of energy, low self‑esteem, poor concentration, indecisiveness, and hostility and irritability all make it difficult for parents to be responsive to the needs of their children and to be good role models for healthy social and emotional functioning. Fourth, the lives of children with depressed parents may be particularly stressful.

Given this context, therefore, it is not surprising that young children of depressed parents have high rates of psychiatric disorder. Indeed, estimates of psychiatric disorder among children of depressed parents range from 41 to 77. Even among children of unipolar depressed parents (which arguably has a weaker genetic component), rates of psychiatric disturbance, including depression, oppositional or conduct disorder, anxiety disorders, and alcohol or drug use and dependency, exceed 40%. Moreover, negative effects of maternal depression on children have been documented across a wide age range, from infancy through adolescence. For example, compared to offspring of non-depressed controls, infants of depressed mothers have been found to be more fussy, to obtain lower scores on measures of mental and motor development, and to have more difficult temperaments and less secure attachments to their mothers. Toddlers of depressed mothers have been found to react more negatively to stress and to be delayed in their acquisition of effective self-regulation strategies. Relative to control children, school­aged children and adolescents whose mothers are depressed have been found to have more school problems, to be less socially competent, and to have lower levels of self‑esteem and higher levels of behavior problems.

Researchers recently have attempted to move beyond an examination of the relatively simple question of whether children of depressed mothers are at risk for abnormal development, and have begun to identify factors that are associated with this risk. Despite this shift in focus, however, we know relatively little about why and how these children are at risk‑that is, we do not have an adequate understanding of the mechanisms that underlie the risk for these adverse outcomes.

Risk might be transmitted through several mechanisms. For example, risk for depression may be transmitted genetically from mother to child. Alternatively, dysfunctional neuroregulatory systems in the children may interfere with emotion regulation processes, leading to increased risk for depression. These dysfunctional neuroregulatory systems may be inherited, or they may be acquired, either prenatally through in utero hazards or postnatally as a function of inadequate parental support of the infants' maturing neurophysiological systems. Other possible mechanisms for the intergenerational transmission of risk for depression involve interpersonal or cognitive processes. Depressed parents, for example, may serve as maladaptive role models for their children and as inadequate social‑emotional partners. They may also model negative cognitive functioning for their children. The stressful context of the lives of children in families with depressed parents may contribute significantly to the development of psychopathology in the children.

Not only are discussions of these potential mechanisms relatively rare, but they are also not found in a single source. The purpose of this volume is to bring together perspectives from diverse theoretical approaches to understanding the transmission of risk for psychopathology in children of depressed parents. Typically, each mechanism focuses on one particular limited age period (e.g., infancy, early childhood, adolescence). Because we believe that it is important to try to account for the transmission of risk for psychopathology over the course of development, we have also tried to structure this volume to achieve this goal. This book provides opportunities to explore integrative approaches to understanding the transmission of risk and to examine clinical implications of these approaches for prevention and treatment of psychopathology in general and of depression more specifically.

In developing and organizing this book, we wanted to cover the major approaches to examining possible processes involved in the intergenerational transmission of risk for depression. We also wanted to ensure that this volume would be relevant and of interest to researchers and clinicians alike. To meet these objectives, we made several requests of the contributors to this volume. We invited the authors to focus on possible mechanisms or moderators of the transmission of risk for depression from parent to child and to discuss how and why, or under what circumstances, parental depression increases children's risk for the disorder. We also encouraged the contributors to take a developmental perspective in writing their chapters. Finally, we asked all of the authors to elaborate on the clinical implications of their work for prevention and intervention. Indeed, to emphasize the clinical relevance of the research described in this volume, we asked all of the authors to include a section in their chapters entitled Implications for Clinicians. This common focus not only underscores the link between research and clinical practice, but also serves to enhance continuity across the chapters.

The chapters contained in Part I deal with mechanisms that might underlie the transmission of risk for psychopathology from depressed parent to child. Silberg and Rutter (chapter 2, this volume). They discuss the interplay of nature and nurture, including gene‑environment correlations and interactions, in increasing children's vulnerability to depression and to other disorders. Ashman and Dawson (chapter 3, this volume) discuss the mechanisms through which inadequate early parenting by depressed mothers may contribute to abnormalities in the development of their children's psychobiological systems involved in emotion expression and regulation. Field (chapter 4, this volume) focuses on the effects of depression occurring during pregnancy, discussing the impact of prenatal exposure to elevated levels of norepinephrine and cortisol and lower levels of dopamine. She describes how this exposure might contribute to neonatal psychobiological dysregulation, which then is exacerbated by inadequate stimulation and arousal modulation from the mothers.

Lyons‑Ruth, Lyubchik, Wolfe, and Bronfman (chapter 5, this volume) argue that depressed parents engage in inadequate early parenting, which, in the context of problematic family relationship patterns, increases the likelihood of insecure attachment. They then discuss insecure attachment as a risk factor for the subsequent development of psychopathology. Garber and Martin (chapter 6, this volume) describe research with older children of depressed parents. They postulate that depressed parents model negative cognitions, engage in dysfunctional parent‑child relationships, and expose their children to stressful life events. All of these mechanisms are hypothesized to increase the risk for the development of negative cognitions in their children, which imparts a vulnerability for the development of depression and other forms of psychopathology. Radke‑Yarrow and Klimes‑Dougan (chapter 7, this volume) describe multiple, co‑acting factors through which depressed parents might influence the emergence of various forms of psychopathology and other adverse developmental courses. In this context, they place special emphasis on normal development in contributing to this process. Finally, Hammen (chapter 8, this volume) discusses the formulation that children of depressed parents experience highly stressful environments, which may set into play additive or interactive processes that contribute to the subsequent development of psychological problems.

Whereas these authors focus on potential mechanisms underlying the transmission of risk, the authors of the chapters contained in Part II examine possible moderators that might help explain how it is that a significant subset of offspring of depressed parents do not develop psychopathology. The three chapters in this section, therefore, deal with moderators of the association between parental depression and child outcomes. We invited the authors to help us to understand the factors that are related to better or worse outcomes among children with depressed parents. Inherent in the emphasis on moderators is the notion of multiple risk factors, which is important for at least two reasons. First, it is unlikely than any single risk factor, including parental depression, accounts for large proportions of the variance in child outcomes. Second, studying parental depression as the single predictor of child outcome ignores individual differences among the children, as well as differences in the contexts within which children are developing. Therefore, we gave three sets of moderators primary consideration: (a) the role of the family (Phares, Duhig, and Watkins, chapter 9, this volume), (b) children's coping processes and adaptation (Compas, Langrock, Keller, Merchant, and Copeland, chapter 10, this volume), and (c) gender (Sheeber, Davis, and Hops, chapter 11, this volume).

Phares and her co-authors elaborate on the role of three family influences on the association between parental depression and child functioning: the co‑parenting dyad, the parent‑child dyad, and the sibling dyads. They propose that children of depressed parents who are also exposed to psychopathology in the other parent, to psychopathology in siblings, or to high levels of familial conflict, are likely to have elevated levels of psychological difficulties. Compas and his colleagues provide an in‑depth exploration of the influence of children's coping responses on the association between parental depression and the development of psychopathology in the children. They present empirical findings suggesting that children's coping responses may mediate the association between exposure to the stressful environments characteristic of depressed parents and the emergence of child psychopathology. In the third chapter in this section, Sheeber and her co‑authors provide a comprehensive review of the literature concerning gender‑specific vulnerability to depression. They propose a diathesis‑stress model to explain the greater likelihood of depression in adolescent girls than boys that also involve the constructs of coping and modeling.

Part III of this book contains two chapters. In the first, Gladstone and Beardslee (chapter 12, this volume) summarize the empirical clinical work that has been conducted with offspring of depressed parents. These authors provide an overview of the findings from empirically based interventions for children with depressed parents, and they make recommendations for further research on both prevention and intervention. In the final chapter, we draw connections across the chapters, highlighting common themes that emerged in the discussions of mechanisms and moderators of the transmission of risk from depressed parent to child. We also discuss clinical implications of these connections for prevention and intervention and outline what we believe are important questions that should guide future research in this area. It is our fervent hope that the discussions in this book concerning both the mechanisms through which the risk for depression is transmitted from depressed parents to their children and the factors that may alter the likelihood that these children will experience an episode of depression will lead researchers and clinicians alike to focus on reducing this risk and developing programs that may prevent the occurrence of this debilitating disorder in the offspring of depressed parents.

Self and Motivation: Emerging Psychological Perspectives by Abraham Tesser, Diederik A. Stapel and, Joanne V. Wood (International Society of Self and Identity: American Psychological Association) Strong on theory and empirical work, Self and Motivation showcases cutting­edge research that asks a variety of intriguing questions: Can goals be activated outside our awareness? How do interpersonal dynamics affect self? How do we maintain a distinctive identity in a group context? Is too much choice or self‑determination "bad"? How does self‑esteem and morality influence self?

Here leading scholars discuss the importance of motivation, emotion, and physiological arousal in self‑related processes; explore the role of awareness in goal‑driven behavior; and describe the interactive influence of social context on self and self on social context. A formal, integrated model of self‑regulation is also proposed.

Up‑to‑date, informative, and engaging, Self and Motivation challenges readers to consider new approaches in studying and thinking about motivation and self.

Self and Motivation is part of the International Society of Self and Identity book series.

The self, like most psychological entities, consists of an organized set of beliefs, feelings, and behaviors. Psychologists' attempts to understand the self from a scientific perspective have tended, in different historical periods, to emphasize behavioral processes, cognitive processes, or affective and motivational processes. Behaviorism was followed by the cognitive revolution, and our crystal ball is beginning to detect an increasing interest in motivation. Research fashions change; different periods have had different emphases. It has always been clear, however, that a complete un­derstanding would necessarily involve all aspects of the self. So, in spite of the increased motivational emphasis, we see it as a productive sign that each chapter in this book also shows a strong sensitivity to all three aspects of self‑functioning.

The research described in the following chapters is on the cutting edge of the discipline. It includes a sophisticated approach to the role of awareness in goal striving, a comprehensive review of physiological re­sponses in self‑defense, a more nuanced and perhaps surprising understand­ing of the motivational significance of choice, and an analytic approach to the emotions of guilt and shame. A couple of chapters go beyond where we have been in our attempts to understand how self and identity processes function in interpersonal and intergroup contexts. Finally, we have a new, integrative formal model of much of what we know about the dynamics of self‑functioning. The mixture is rich, and many of the ideas are provocative and new. We hope that readers find them useful and interesting.

Taken from: http://www.wordtrade.com/socie.....hology.htm

September 17, 2003
5:53 pm
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Ladeska.

You posted:

"The self, like most psychological entities, consists of an organized set of beliefs, feelings, and behaviors. Psychologists' attempts to understand the self from a scientific perspective have tended, in different historical periods, to emphasize behavioral processes, cognitive processes, or affective and motivational processes. ... ... ..."

When human beings, who believe in the existence of a 'self' that needs salvation, are forced to face both their own vulnerability and their relative powerlessness in the face of real or perceived threats to that 'self', depression is often inevitable.

But does the 'self' really exist outside of our ego based demand for its own validation? Isn't the 'self' just a collection of synaptically based memories that consciousness uses to construct the illusion?

"
10 November 2002 Joseph LeDoux New York University

The synaptic self

Without synaptic plasticity, learning--and the self--would be impossible.

BY ETIENNE BENSON

If who we are is shaped by what we remember, and if memory is a function of
the brain, then synapses--the interfaces through which neurons communicate
with each other and the physical structures in which memories are
encoded--are the fundamental units of the self. That was the message of a
talk given at APA's 2002 Annual Convention by New York University
psychologist and neuroscientist Joseph LeDoux, PhD.

"Synapses are pretty low on the totem pole of how the brain is organized,
but I think they're pretty important," said LeDoux.

The self, he suggested, is the sum of the brain's individual subsystems,
each with its own form of "memory," together with the complex interactions
among the subsystems. Without synaptic plasticity--the ability of synapses
to alter the ease with which they transmit signals from one neuron to
another--the changes in those systems that are required for learning would
be impossible.

LeDoux's research has focused on the network of brain regions responsible
for detecting and responding to threatening stimuli. At the center of that
network is the amygdala, the almond-shaped cluster of neurons near the base
of the brain that stores memories of fearful stimuli and triggers fear
responses.

Studies have shown that there are two pathways through which the amygdala's
fear responses can be triggered: a fast "low road" from the thalamus to the
amygdala, and a slower "high road" that passes from the thalamus to the
neocortex and only then to the amygdala, said LeDoux. The two paths do not
always reach the same conclusions, he explained. The relatively crude "low
road" may respond to a long, thin object as a dangerous snake--and trigger
an immediate fear response--while the slower "high road" is determining
that the object is a harmless stick.

Evolutionarily speaking, it may make sense for the faster pathway to err on
the side of caution, said LeDoux; after all, "it's probably better to treat
a stick as a snake than a snake as a stick." But the disconnection between
"low" and "high" roads, which was first discovered in rats but has since
been corroborated in humans, could also be responsible for some
psychopathologies. "We know that lots of people have fears that they can't
come to conscious terms with," said LeDoux. "People who have pathological
fears may be treating sticks as snakes all the time, metaphorically."

One of the biggest challenges in neuroscience, said LeDoux, is discovering
how individual systems like the fear network are related to other systems,
and how all of the brain's systems together create the collection of
behaviors we call the "self." Although we know of a number of factors that
could bind the brain's subsystems together--including shared inputs, neural
"convergence zones," and the diffuse effects of neurotransmitters like
serotonin--the details remain a mystery, said LeDoux.

The insights we gain from exploring the brain can give us new ways of
thinking about psychology, he added. For instance, research on the neural
underpinnings of emotion and cognition has shown that the amygdala sends
projections to almost every part of the brain, including regions
responsible for high-level cognition, but the number of projections back to
the amygdala from cognitive regions is small. That insight may help explain
why emotion can sometimes overpower cognition.

"Emotional systems tend to monopolize brain resources," said LeDoux. "It's
much easier for an emotion to control a thought than for a thought to
control an emotion."
"

So is depression not the result of perceived cognitive powerlessness in the face of over-stimulated fear based emotions!

Since belief in the existence of the 'separate, independent self' that desperately needs defending against 'bogey men' appears to be the Achillies heel of the intellect, perhaps examining at depth the basis upon which most of us pin this belief, is partly the answer to overcoming depression.

September 17, 2003
6:42 pm
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That may very well be, Tez. Just something we as yet - do not know.

Alot of things are locked up in perception and what we call things as opposed to "what they really are in reality".

Otherwise, we'd still think the world is flat, huh?

The "bogey men" within the human drama is an age old tactic of many a witch in front of a caldron or priest in front of his flock, or tyrant in front of his subjects. And it's an ancient military strategy. You create your own enemy so that you always know - what your enemy is up to.

Our obssession with many fears is basically a fear of life itself. Fear of the unknown, fear of what we cannot readily take control of and disect, name and put in a shadow box with "our name attached to it".

Kind of a thing I think that is summed in - being afraid to be very present in the moment, exposed and naked.

Like we can't have an original thought unless someone rubber stamps it, approves it, makes a committee about it and wants to begin a religion based on it.

Many times we study the symptoms and go backwards instead of correctly finding the origin and working forwards. But origins are murky sometimes, sort of like the yellow brick road to the wizard. Even in Emerald City things get ever more dangerous.

Sometimes people's fears and incorrect perceptions is all they have and all they are willing to hang onto and trying to pry those white knuckles away - is far from easy. People don't part ways very well with their icons and dragons and myths.

My God will beat your God and if that doesn't work - you better sure as hell run from the demons I'm about to unleash on you!!!

Thus the reason why...........we are all about to blow each other up here instead of figuring out how to live in peace and harmony on this planet.

Actually I posted this for various reasons. One thing of particular interest was the part about how a pregnant mother can basically "imprint" her child in the womb if she is going through something traumatic. Her own natural chemicals and stress hormones that are pumping through her, helping her deal with the stress, also goes to her baby and can greatly affect that baby and dial in some interesting codes.

I've just watched certain women who were carrying babies and having a difficult time in their lives - and then look at the baby afterwards and see a baby who will not be comforted, who does not sleep well, easily agitated, etc., etc. And yet, I look at mothers who carry their children in a very peaceful and placid way and their children seem to reflect that as well.

September 19, 2003
7:24 pm
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Ladeska.

You said: "A lot of things are locked up in perception and what we call things as opposed to "what they really are in reality". "

It seems to me that to discover "reality" one must lose all the preconceptions upon which our "normal" perceptions are based.

The opening stanza od Seng Ts'an's poem "The Mind of Absolute Trust" as translated by Hsin Hsin Ming states that:

"The Great Way is not difficult

for those who have no preferences.

When love and hate are both absent

everything becomes clear and undisguised.

Make the smallest distinction, however,

and heaven and earth are set infinitely apart.

If you wish to see the truth

then hold no opinions for or against anything.

To set up what you like against what you dislike

is the disease of the mind.

When the deep meaning of things is not understood

the mind’s essential peace is disturbed to no avail."

Perhaps the preconditioning that has already taken place long before a baby is born is one cause that meets the conditions within the mother's womb that sets in place the start of the chain of conditioning that culminates in the discriminating adult psyche.

Oh to be able to cut through this conditioning as a hot knife through butter.

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