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Research on the development of theory of mind (ToM), the understanding of people in relation to mental states and emotions, has been a vibrant area of cognitive development research. Because the dominant focus has been addressing when children acquire a ToM, researchers have concentrated their efforts on studying the emergence of psychological understanding during infancy and early childhood. Here, the benchmark test has been the false-belief task, the awareness that the mind can misrepresent reality. While understanding false belief is a critical milestone achieved by the age of 4 or 5, children make further advances in their knowledge about mental states and emotions during middle childhood and beyond. Thus, a comprehensive understanding of children's sociocognitive abilities in older age groups is necessary to understand more fully the course of ToM development. The aim of this review is to outline continued development in ToM during middle childhood. In particular, we focus on children's understanding of interpretation—that different minds can construct different interpretations of the same reality. Additionally, we consider children's growing understanding of how mental states (thoughts, emotions, decisions) derive from personal experiences, cohere across time, and interconnect (e.g., thoughts shape emotions). We close with a discussion of the surprising paucity of studies investigating individual differences in ToM beyond age 6. Our hope is that this chapter will invigorate empirical interest in moving the pendulum toward the opposite research direction—toward exploring strengths, limitations, variability, and persistent errors in developing theories of mind across the life span.

Background:The Canadian Network for Mood and Anxiety Treatments (CANMAT) has revised its 2009 guidelines for the management of major depressive disorder (MDD) in adults by updating the evidence and recommendations. The target audiences for these 2016 guidelines are psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. “Psychological Treatments” is the second of six sections of the 2016 guidelines. Results: Evidence-informed responses were developed for 25 questions under 5 broad categories: 1) patient characteristics relevant to using psychological interventions; 2) therapist and health system characteristics associated with optimizing outcomes; 3) descriptions of major psychotherapies and their efficacy; 4) additional psychological interventions, such as peer interventions and computer- and technology-delivered interventions; and 5) combining and/or sequencing psychological and pharmacological interventions. Conclusions: First-line psychological treatment recommendations for acute MDD include cognitive-behavioural therapy (CBT), interpersonal therapy (IPT), and behavioural activation (BA). Second-line recommendations include computer-based and telephone-delivered psychotherapy. Where feasible, combining psychological treatment (CBT or IPT) with antidepressant treatment is recommended because combined treatment is superior to either treatment alone. First-line psychological treatments for maintenance include CBT and mindfulness-based cognitive therapy (MBCT). Patient preference, in combination with evidence-based treatments and clinician/system capacity, will yield the optimal treatment strategies for improving individual outcomes in MDD.

Background: An important cognitive marker of clinical depression is a reduced ability to be specific in recalling personal memories, a phenomenon coined ‘overgeneral memory’. Overgeneral memory is considered as a stable cognitive trait that is intrinsically linked with depression and independent of mood state. Previous studies show that autobiographical memory is modifiable. Sampling and Methods: This study investigated whether autobiographical memory is differentially affected by treatment type. Depressed patients were randomly assigned to receive either cognitive behavior therapy (CBT) for depression or pharmacotherapy (PHT). Results: The proportion of categoric memories decreased and the proportion of specific memories increased following both types of treatments, adding support to the view that overgeneral memory is modifiable. CBT also had a greater impact on reducing extended overgeneral memories compared to PHT. Conclusions: The results from the current study are important in that they show that overgeneral memory can be targeted and modified through brief treatment. The clinical significance of the finding that there was a greater decrease in extended memories in the CBT group is unclear.

CONTEXT:Episode remission in unipolar major depression, while distinguished by minimal symptom burden, can also be a period of marked sensitivity to emotional stress as well as an increased risk of relapse. OBJECTIVE: To examine whether mood-linked changes in dysfunctional thinking predict relapse in recovered patients who were depressed. DESIGN: In phase 1 of this study, patients with major depressive disorder were randomly assigned to receive either antidepressant medication or cognitive behavior therapy. In phase 2, patients who achieved clinical remission underwent sad mood provocation and were then observed with regular clinical assessments for 18 months. SETTING: Outpatient psychiatric clinics at the Centre for Addiction and Mental Health, Toronto, Ontario. PARTICIPANTS: A total of 301 outpatients with major depressive disorder, aged 18 to 65 years, participated in phase 1 of this study and 99 outpatients with major depressive disorder in remission, aged 18 to 65 years, participated in phase 2. MAIN OUTCOME MEASURE: Occurrence of a relapse meeting DSM-IV criteria for a major depressive episode as assessed by the longitudinal interval follow-up evaluation and a Hamilton Depression Rating Scale score of 16 or greater. RESULTS: Patients who recovered through antidepressant medication showed greater cognitive reactivity following the mood provocation than those who received cognitive behavior therapy. Regardless of type of prior treatment, the magnitude of mood-linked cognitive reactivity was a significant predictor of relapse over the subsequent 18 months. Patients whose mood-linked endorsement of dysfunctional attitudes increased by a minimum of 8 points had a significantly shorter time to relapse than those whose scores were not as elevated. CONCLUSIONS: The vulnerability of remitted depressed patients for illness relapse may be related to the (re)activation of depressive thinking styles triggered by temporary dysphoric states. This is the first study to link such differences to prognosis following successful treatment for depression. Further understanding of factors predisposing to relapse/recurrence in recovered patients may help to shorten the potentially lifelong course of depression.

To systematically search for the availability of evidence for exercise impacting on sleep for people who have rheumatoid arthritis. Two reviewers independently searched seven electronic databases, identified and extracted relevant studies by applying eligibility criteria. Sources of bias were assessed independently by two reviewers using the Cochrane bias assessment tool for randomized controlled trials (RCTs) and Newcastle-Ottawa Quality Assessment Scale for non-RCTs. Data were synthesized using a level of evidence approach. Meta-analyses were deemed to be inappropriate due to the heterogeneity of study designs, measurement tools and interventions. Five studies were included: one RCT; two pilot RCTs and two samples of convenience. A total of 262 people with RA were included. Interventions used were difficult to assess due to the heterogeneity of study designs and the inclusion of two using different types of yoga as an intervention. Different sleep outcome measures were used thus, it was not feasible to pool results. Studies had a high risk of bias. This review could find no consistent or conclusive evidence on whether exercise impacts on sleep in people who have rheumatoid arthritis, therefore no firm conclusions can be made. However, there is some indication that exercise may have positive benefits on sleep in people who have rheumatoid arthritis. Further studies with improved study designs, using subjective and objective measures, are needed.

Through readings of two "walking memoirs"—W. G. Sebald's The Rings of Saturn and Raja Shehadeh's Palestinian Walks—this article considers the implications of the geological concept of the Anthropocene era for the field of life writing studies and its understanding of the human. It considers the ways these and other authors imagine the human, and the costs of the human pursuit of freedom for other species and things, from a planetary perspective.

A 34-year-old woman carrying a BRCAI gene and a significant family history was diagnosed with TIc, NI breast cancer. The tumor was estrogen receptor, progesterone receptor, and HER-2/Neu negative. The patient received dose-dense chemotherapy with Adriamycin and Cytoxan followed by Taxol, and left breast irradiation. Later, a bilateral S-GAP flap reconstruction with right prophylactic mastectomy and left mastectomy were performed. During her treatment, the patient had an integrative medicine consultation and was seen by a team of health care providers specializing in integrative therapies, including integrative nutrition, therapeutic massage, acupuncture, and yoga. Each modality contributed unique benefit in her care that led to a satisfactory outcome for the patient. A detailed discussion regarding her care from each modality is presented.The case elucidates the need for integrative approaches for cancer patients in a conventional medical setting.

Z. V. Segal et al. (2006) demonstrated that depressed patients treated to remission through either antidepressant medication (ADM) or cognitive-behavioral therapy (CBT), but who evidenced mood-linked increases in dysfunctional thinking, showed elevated rates of relapse over 18 months. The current study sought to evaluate whether treatment response was associated with gains in decentering-the ability to observe one's thoughts and feelings as temporary, objective events in the mind-and whether these gains moderated the relationship between mood-linked cognitive reactivity and relapse of major depression. Findings revealed that CBT responders exhibited significantly greater gains in decentering compared with ADM responders. In addition, high post acute treatment levels of decentering and low cognitive reactivity were associated with the lowest rates of relapse in the 18-month follow-up period.

A School for Healing: Alternative Strategies for Teaching At-Risk Students describes an alternative school that dealt with students who were expelled or suspended from public school and who perceived themselves as victims of injustice. It was assumed that they misinterpreted the facts of various situations or chose inappropriate strategies to correct real injustices. The task of the school was to help the students learn multiple perspectives for interpreting the actions of others and to teach them more appropriate ways of resolving injustices. Four students in the school relate their problems and describe, through a qualitative research interview process, how the school helps them. The book describes specific strategies the school used and concludes with suggestions to those who wish to establish a similar program.

A School for Healing: Alternative Strategies for Teaching At-Risk Students describes an alternative school that dealt with students who were expelled or suspended from public school and who perceived themselves as victims of injustice. It was assumed that they misinterpreted the facts of various situations or chose inappropriate strategies to correct real injustices. The task of the school was to help the students learn multiple perspectives for interpreting the actions of others and to teach them more appropriate ways of resolving injustices. Four students in the school relate their problems and describe, through a qualitative research interview process, how the school helps them. The book describes specific strategies the school used and concludes with suggestions to those who wish to establish a similar program.