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PsychNotes April 2013
by Monica A. Frank, Ph.D.
Clinical and Sport Psychologist

Index        Previous        Next

April 28, 2013


Depression can often be stigmatizing for those who suffer with it. Frequently, they are made to feel as if they are weaker than others for being depressed. In cases of trauma this may be particularly felt because they may be compared to some people who experience trauma but don't have depressive or anxious reactions.

Why is it that trauma can cause severe distress, anxiety, and depression in some whereas others don't appear to be affected? The answer to this is related to how depression is frequently misunderstood. Many, if not most, people think of depression as an inability to handle negative emotions or stress. However, depression is a PHYSICAL illness unrelated to ability to manage emotions or life experiences.

As with any consuming, chronic physical illness that causes serious physical symptoms such as fatigue and low energy, it becomes much more difficult to deal with stressors or trauma because it is added to the demands of the physical illness. This is the classical “straw that broke the camel's back” scenario in that if the physical illness (depression) wasn't present it may be easier to manage the other life stressors.

So why is it that many people experience depression when trauma or extreme stress occurs? Most likely because they already have a genetic tendency to develop the physical illness of depression which is triggered by the stress of the trauma. In addition, it may be compounded by the lack of coping skills.

However, it is NOT due to weakness. Imagine having to walk across a busy street. Not too difficult of a task, right? However, now imagine having to cross that same street with a boulder tied to your back. That is what it is like to have depression. People with depression are having to face life stressors or traumas with the added burden of the depressive illness. Therefore, they require more strength that most people to face the same situations.

Listen to Depression Assistance audio for more info.

April 27, 2013


sheep The old sleep remedy of counting sheep when having trouble falling to sleep may have some validity. However, some modifications may be necessary. In particular, counting sheep may be too boring so the likelihood of focusing on other distracting thoughts increases (Harvey & Payne, 2002). However, researchers taught individuals with insomnia to focus on a neutral train of thought that does not cause tension or agitation. The outcome of the study showed that the majority of subjects were able to use the technique consistently and that time to fall asleep decreased significantly and amount of sleep obtained nightly increased significantly (Gellis, 2012).

To use this technique, you need to choose three different thought topics that can hold your attention but not cause agitation or arousal. Even something too interesting can be arousing so you need to carefully select your topics. You use only one of the topics so that you become accustomed to it, but have the other two available in case the first topic doesn't hold your attention well enough. Then whenever you go to bed or wake up at night focus on the chosen topic of thought. Do not look at the clock in the middle of the night or engage in other thought.

Gellis, L.A. (2012). An Investigation of a Cognitive Refocusing Technique To Improve Sleep, Psychotherapy, 49, 251–257.

Harvey, A.G. And Payne, S. (2002). The management of unwanted pre-sleep thoughts in insomnia: distraction with imagery versus general distraction, Behavioral Research and Therapy, 40, 267-277.

April 18, 2013


Generally, couples who are kind to one another report a higher degree of marital satisfaction. However, research shows that unkindness can lead to greater marital satisfaction depending upon the circumstances (McNulty & Fincham, 2012).

Specifically, criticism that occurs due to minor issues is likely to lead to decreased marital satisfaction. For example, “You didn't mow the lawn like you said you would” or “This house is a mess” or “You never buy me flowers.” However, criticism focused on serious issues is likely to lead to greater marital satisfaction over time. For example, “When you stay out late drinking it affects our home life” or “You are spending too much.”

The reason for this is that criticism regarding serious issues is likely to lead to problem resolution. Although, the criticism may cause initial conflict, it can create a more satisfying relationship in the long run. Whereas minor criticisms erode the relationship a little at a time.

So, be kind and let go of the minor issues. But don't ignore the major issues for the sake of keeping peace or not wanting to hurt feelings.

McNulty, J.K. & Fincham, F.D. (2012). Beyond Positive Psychology? Toward a Contextual View of Psychological Processes and Well-Being, American Psychologist, 67, 101-110.

April 17, 2013


As Oscar Wilde said “Everything in moderation, including moderation,” we need to be cautious interpreting the research on optimism and happiness. Although optimism has been shown to be associated with greater well-being and happiness, blind optimism can cause significant problems (McNulty & Fincham, 2012).

In psychological terms we would call this “denial.” So, if a person is optimistic to the degree that they don't recognize problems, they are in denial. “I can handle one or two drinks” says the alcoholic. “A winning streak is just around the corner” says the gambler. “He promised he will change” says the abused wife.

Optimism IS important to well-being but it needs to be balanced with realistic problem-solving. If a person is optimistic about solving problems such as “Whatever happens, I can handle it” then they are likely to be more persistent and make changes that can lead to beneficial life experiences. However, if they are optimistic about uncontrollable situations or luck, then they may be in denial which can be harmful.

McNulty, J.K. & Fincham, F.D. (2012). Beyond Positive Psychology? Toward a Contextual View of Psychological Processes and Well-Being, American Psychologist, 67, 101-110.

April 16, 2013


Do you believe that you should always strive to forgive when others have hurt you? Although the tendency to forgive has been associated with a greater level of well-being and happiness, research indicates that forgiveness may also be detrimental depending upon the situation. For instance, in a healthy relationship, forgiveness leads to greater contentment in the relationship. However, in unhealthy relationships, forgiveness can lead to increased aggression and/or transgressions against the forgiver (McNulty & Fincham, 2012).

What this indicates is that when forgiveness follows the resolution of problems it is beneficial to the relationship. However, if no problem-solving occurs, then forgiveness may be seen as passivity or weakness which frequently gives permission for the transgressor to cause further harm. In such a case forgiveness does not lead to greater well-being.

Keep in mind that problem-solving does not have to involve the transgressor. For example, it can be a decision by the person who was harmed regarding how to further protect him or herself. At which time a decision to forgive may be more for the benefit of letting go of the past and then can lead to greater well-being.

McNulty, J.K. & Fincham, F.D. (2012). Beyond Positive Psychology? Toward a Contextual View of Psychological Processes and Well-Being, American Psychologist, 67, 101-110.

April 15, 2013


Everyone forms impressions when meeting new people. We rely on forming impressions to help us quickly decide how to manage a new situation or how to respond to someone. Therefore, it is critical that our ability to judge is accurate. Otherwise, we will respond in ways that may not be in our best interests or beneficial for the situation.

People with social anxiety are fearful of being evaluated negatively and expect such from others. They often over-interpret others' behavior and comments as negative or critical of them when that may not be the intention. Much previous research has shown this tendency.

However, researchers Aderka et al. (2012) found that people with Social Anxiety Disorder (SAD) showed bias when forming opinions of others in situations where no evaluation was present. The study participants were asked to socially rank descriptions of others that were provided to them. During this computer-aided task they were given the opportunity to obtain further information. However, those with SAD were less likely to seek more information. In addition, compared to participants who did not have SAD they tended to rank dominant others higher.

Such responses indicate that people with social anxiety may limit their initial impressions of others, especially those they perceive at a higher rank, by not seeking more information. By doing so, they are more likely to maintain their initial impression of others as critical of them. Without paying attention to new information it may confirm their impression of the social world as threatening to them.

How can this be changed? The individual with social anxiety may need to make deliberate attempts to seek out more information about others before forming impressions. Recognizing the bias, in itself, can help the socially anxious person. For instance, “I tend to form impressions without seeking further information which might bias me based upon my fears of being evaluated. I need to try and get more information before forming an impression of others.”

This may also be important information for socially anxious people to understand about how others form impressions. Generally, it is human nature to assume that others think the same way we think. However, in this case, the socially anxious person can say to him or herself, “Others don't tend to form opinions as quickly as I do. I need to be careful when making the assumption that others immediately judge me negatively.”

Aderka, I.M., Haker, A., Marom, S., Hermesh, H. and Gilboa-Schechtman, E. (2013). Information-Seeking Bias in Social Anxiety Disorder, Journal of Abnormal Psychology, 122, 7–12.

April 7, 2013


According to the Centers for Disease Control and Prevention in 2007 almost 10% of U.S. children between the ages of 5-17 have been diagnosed with ADHD whereas the American Psychiatric Association (APA) estimates that the prevalence of ADHD is 3-7%. Since the APA bases its estimate on controlled studies using consistent criteria this discrepancy would seem to indicate an over-diagnosis of ADHD.

Over 65% of the children diagnosed with ADHD receive medication. Using these statistics from the CDC, if we assume the statistics for medication being prescribed is the same whether the diagnosis was accurate or inaccurate, this would mean that 20%-40% of children diagnosed with ADHD are improperly receiving medication.

Yet, the American Academy of Pediatrics (2011), a physician group, recommends that the first line of treatment should be behavioral treatment. Given not only this recommendation by ACP but also the high level of misdiagnosis, it would seem reasonable to pursue behavioral treatment prior to prescription medicine. This has particular significance as most medication prescribed for ADHD is stimulant or amphetamine-type medication which has great potential for abuse.

However, behavioral treatment is much more difficult because it requires active parental and teacher involvement. A recent review of non-pharmacological treatment for preschool children with ADHD showed that training parents and teachers to provide consistent limits and consequences can significantly improve the behavior of children with ADHD (Rajwan, et al., 2012).

Plus, the methods taught are appropriate for improving the behavior of any children. It would seem much better to pursue such an alternative prior to medicating children. Then, perhaps only the most severe cases would be prescribed medication which may also reduce medicating of misdiagnosed children.

American Academy of Pediatrics. (2011). ADHD: Clinical practice guidelines for the diagnosis, evaluation and treatment of attention deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128, 1007–1022.

Rajwan, E., Chacko, A., and Moeller, M. (2012). Nonpharmacological Interventions for Preschool ADHD: State of the Evidence and Implications for Practice. Professional Psychology: Research and Practice, 43, 520–526.

April 4, 2013


“Just enough” parenting is to provide the child with the needed assistance to teach skills but not be overly involved.“Scaffolding” is a term used in the psychological literature to describe a parenting style in which a parent observes the child's level of understanding and assists a child only as needed. In other words, the parent is neither uninvolved, nor over-involved. The scaffolding style allows the child to learn how to do something as the child is physically and cognitively able. The scaffolding style has been associated with higher level of parental education. In my opinion that may be due to those parents having greater opportunity to be presented such information.

For example, many parents assume that because their child does not clean his/her room as asked, it is because the child is lazy, disrespectful, or resistant. However, it may be due to the child not having learned the necessary organizational tools to attack such a task. Don't assume that just because the child has observed you cleaning that the child has learned how to do it!

A parent using scaffolding recognizes that every task is a teaching opportunity. In fact, many parents believe that their job as a parent is to make their children behave. And some, when failing that, just give up. However, the job of a parent is to teach the child the necessary skills for adulthood.

Therefore, cleaning their room is a great opportunity to teach skills. In particular, cleaning a room means learning how to look at a large project, break it down into smaller components, and developing a plan. These are great organizational tools to learn!

The scaffolding technique requires the parent to assist and observe a behavior. In the case of cleaning their room, the parent might gently prod with questions such as “Where do you think you could start? Then what could you do?” This allows the parent to understand the child's thought process. If the child seems stuck the parent can suggest “What about picking up the dirty clothes first?” The parent allows the child to continue as the child is able but if the child becomes stuck the parent can assist with suggestions or showing the child how to do something.

In this way, the parent does not take over the project but uses the situation to teach the child how to tackle cleaning his/her room. This method may require more effort on the parent's part initially but it will teach a child how to organize and manage a complex problem.

In addition, the parent should be careful to not assume that just because the child has been shown previously, that the child knows how to do it. Think about when you've gotten a new job—did you learn all the policies and procedures with only being shown once?

Scaffolding isn't easy but when applied to all the tasks a child must do such as homework or sports or writing a thank you note it prepares a child for adulthood.

Carr, A. and Pike, A. (2012). Maternal Scaffolding Behavior: Links With Parenting Style and Maternal Education. Developmental Psychology, 48, 543–551.

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