Pathways to care for Alzheimer's disease among Korean Americans

Little is known about how Korean Americans make decisions whether to seek help when, experiencing symptoms that might signal dementia. In Study 1, patient registry data for 60 Korean and 212 non-Korean Alzheimer's disease patients revealed that both groups waited 3-4 years before seeking help and sought help when memory decline was accompanied by other problems. Among Korean Americans, those living with family were more impaired than those living alone, suggesting greater, delay in seeking help. In Study 2, 109 Korean Americans ages 18-73 were surveyed concerning acculturation, knowledge, and help-seeking attitudes. Those more familiar with dementia symptoms indicated they would seek help, supporting the value of public education.     

Family protective factors among urban African American youth.

Examined the relations among family protective factors, stressful events, and behavioral adjustment of 64 African American 6th graders. The youths reported on family stressors, father-figure involvement, and kin support. Their primary caregivers reported on parenting, father-figure involvement, and family stressors. Teachers reported on child social skill deficits, acting out, and shy or anxious behavior. Based on regression analyses, stress exposure associated positively with child social skill deficits, acting out, and shy or anxious behavior. Parental warmth was associated negatively with shy or anxious behavior. Parental use of corporal punishment was associated positively with child acting out. For youth exposed to high numbers of family stressors, parental demandingness was associated negatively with child acting out and kin support was associated negatively with acting out and shy or anxious behavior, suggesting that these family factors partially shield children from the negative effects of stress.     

Medication adherence and diabetes control in urban African Americans with type 2 diabetes.

In 181 urban African Americans with Type 2 diabetes, medication adherence was assessed using a measure designed specifically for an urban, impoverished sociodemographic population. Hemoglobin A-sub(1c), blood pressure and cholesterol levels, medication-related beliefs, and depression were assessed. Seventy-four percent of the sample reported adherence to diabetes medication. Adherence, adjusted for age, was associated with lower hemoglobin A-sub(1c). The specific behaviors associated with poorer diabetes control were forgetting to take medications and running out of medications. Knowledge of blood glucose goals differed for adherers and nonadherers. Blood pressure and cholesterol medication adherence rates were not associated with actual levels of blood pressure or lipids, respectively. These data suggest that specific medication-taking behaviors are important to diabetes control and constitute logical targets for interventions. ((c) 2005 APA, all rights reserved).     

"I want to be a daddy!": meanings of masculine identifications in girls

This paper suggests revisions in our understanding of feminine identity formation, the girl's negative oedipus complex, and masculine identifications in girls. Analytic material from the cases of three girls is used to explore the various origins and intrapsychic functions of masculine identifications at each phase of the girl's development. Accounts of feminine development based on such concepts as castration shock, primary femininity, primary identification with mother, or core gender identity are seen as oversimplified. Feminine and masculine identifications are neither primary nor secondary, but the product of a long line of development, of ongoing conflict resolution, and of defensive transformations.     

Racism as a stressor for African Americans. A biopsychosocial model.

Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.     

I want to be creative: exploring the role of hedonic contingency theory in the positive mood-cognitive flexibility link

Three studies explored the role of hedonic contingency theory as an explanation for the link between positive mood and cognitive flexibility. Study 1 examined the determinants of activity choice for participants in happy, sad, or neutral moods. Consistent with hedonic contingency theory, happy participants weighted potential for creativity as well as the pleasantness of the task more heavily in their preference ratings. In Study 2, participants were given either a neutral or mood-threatening item generation task to perform. Results illustrated that happy participants exhibited greater cognitive flexibility in all cases; when confronted with a potentially mood-threatening task, happy participants were able to creatively transform the task so as to maintain positive mood and interest. Finally, Study 3 manipulated participants' beliefs that moods could or could not be altered. Results replicated the standard positive mood-increased cognitive flexibility effect in the nonmood-freezing condition, but no effects of mood on creativity were found in the mood-freezing condition. These studies indicate that the hedonic contingency theory may be an important contributing mechanism behind the positive mood-cognitive flexibility link.     

I want it and I want it now: Using a temporal discounting paradigm to examine predictors of consumer impulsivity

This paper proposes a new model of consumer impulsivity, using type of good, a person's endorsement of materialistic values, and identity deficits as predictors. Traditional decision making and psychological accounts see impulsive behaviour as a general overweighing of short‐term gratification (I want that dress now) relative to longer‐term concerns, irrespective of consumer good. Our proposal is that consumers' impulsivity (a) differs according to type of good and (b) is linked systematically to a combination of materialistic values and high identity deficits. Beginning with Study 1, three experiments, using a temporal discounting paradigm, show consistently that discount rates are higher for goods that are seen as highly expressive of identity (e.g., clothes) than goods not expressive of identity (e.g., basic body care products). For materialistic consumers, identity deficits predict discount rates for identity‐expressive goods (Study 2), and discount rates change for materialistic individuals when their identity deficits are made salient (Study 3). These findings support a conceptualization of consumer impulsivity as identity‐seeking behaviour.     

Perceived racial discrimination as a barrier to college enrollment for African Americans

African Americans trail European Americans in terms of academic achievement, even when accounting for differences in socioeconomic status. One cause of this gap may be racial discrimination. In the current article the authors hypothesized that early perceived racial discrimination (by 5th grade) would predict college enrollment, mediated by changes from 7th grade to 10th grade in academic orientation, college aspirations and expectations, and deviance tolerance. Participants were 750 African Americans from the Family and Community Health Study. A structural equation model that controlled for socioeconomic status and earlier academic performance supported the hypothesis, with the exception that discrimination did not influence aspirations. The effect of discrimination on expectations, however, was moderated: Participants with high future orientation maintained high expectations in spite of discrimination. These results suggest that discrimination discourages some African Americans from pursuing higher education and that increasing future orientation may promote African Americans' college enrollment.     

Self-other similarity judgment asymmetries reverse for people to whom you want to be similar

People typically judge themselves to be less similar to others than others are to themselves. The selective accessibility model [Mussweiler, T. (2003). Comparison process in social judgement: mechanical consequences. Psychological Review, 110, 472-489.] suggests that the direction of this self-other similarity asymmetry could reverse for comparison others to whom people want to be more similar. Motivation to be more similar is thought to prompt a focal hypothesis of similarity as opposed to dissimilarity, which influences the amount and kind of information accessed when making the judgment. A study found a typical asymmetry for comparison others to whom participants did not wish to be more similar, and a reversed asymmetry for comparison others to whom participants did wish to be more similar. The direction of the asymmetry was not dependent on whether participants knew a lot or a little about the comparison other.     

A model of stage of change to recommend colonoscopy among urban primary care physicians.

Theory is little used in the prediction of physician cancer screening stage of change. Structural equation modeling was used to evaluate the theoretical predictors of stage of change to recommend colonoscopy among 235 urban physicians. Constructs from the theory of planned behavior, social-cognitive theory, and the transtheoretical model were systematically tested. As predicted, contextual factors, such as the physicians' ages, their race-ethnicities, patient race-ethnicity, and office-related barriers to preventive care were associated with stage of change through self-efficacy, normative beliefs, and negative behavioral beliefs. The findings demonstrate the relevance of these models to studying the behavior of physicians and support the development of interventions that are tailored to normative beliefs and specific physician cognitions for colonoscopy recommendation.     

Identification and impact of risk and protective factors for drug use among urban African American adolescents.

Identified 10 risk and 12 protective factors associated with drug use among African American 8th graders (N = 994) in an urban school system. Regression analyses identified 7 risk and 7 protective factors with minimal overlap. The total number of risk factors was significantly related to the prevalence of use for cigarettes, beer or wine, liquor, marijuana, and a composite measure of drug use. The Protective Factor Index (PFI) was a significant moderator of the relation between risk and use of beer or wine, liquor, marijuana, and the composite measure. Longitudinal analyses of data on 650 students across the transition from middle to high school indicated that the sum of risk factors predicted changes in all drug use categories except the composite. The PFI significantly predicted changes in beer or wine, liquor, and composite drug use over this 1-year period. It also moderated risk for cigarette use, but not for other drugs. Results replicated prior studies and highlighted the importance of protective factors such as adaptive functioning in school and family influences.     

Smoking involvement during adolescence among African Americans and Puerto Ricans: risks to psychological and physical well-being in young adulthood

The major aim of this study was to examine the longitudinal association between adolescent smoking involvement and self-reported psychological and physical outcomes in young adulthood. Participants included 333 African Americans and 329 Puerto Ricans who were surveyed in 1990 in their New York City schools and interviewed in 1995 and 2000-2001, primarily in their homes. The psychological outcomes included ego integration, symptoms of depression, anxiety, and interpersonal difficulty. The physical health measures included a general health rating, number of illnesses, and symptoms of ill health. Also, three scales measured problems due to alcohol, marijuana, and other illicit drug use. Smoking involvement varied by age, sex, and ethnicity but not by socioeconomic status nor by late adolescent parental status. Analysis showed that the relationships between adolescent smoking involvement and psychological and physical health problems in young adulthood remained significant even with control on demographic factors, earlier levels of the outcome variables, and marijuana use. The relationships between smoking behavior and problems with alcohol, marijuana and other illicit drug use were particularly strong. Thus, adolescent smoking seems to have a wide range of clinical implications for young adulthood.     

Mental health services for African Americans: a cultural/racial perspective

African Americans have made consistent progress toward first-class citizenship since 1965. Nonetheless, mental health services for this population have been biased, incomplete, and deficient because similarities to European Americans have been emphasized whereas differences were largely ignored. This article addresses some differences, including cultural/racial identity and the cultural self, that affect assessment, psychiatric diagnoses, and psychotherapy or other interventions. An assessment-intervention model illustrates how cultural information can inform service delivery and improve services to African Americans. Cultural/racial perspectives on mental health in a multicultural society suggest innovations in the design of these services and access to them that can increase utilization by African Americans.     

Finding a place to be: ethnic identity exploration of Asian Americans

This paper examines the nature of ethnic identity development by analyzing published autobiographical accounts of 39 Asian Americans. Focusing on what previous research indicates is a four-stage ethnic identity formation process, this investigation of the last two stages--ethnic emergence and ethnic identity incorporation--revealed a pattern of exploration and decision-making that results in greater understanding of self-identity and greater self-acceptance as a member of an ethnic minority. The process revealed by the narrators began with a willingness to face previously unaddressed ethnic identity issues, leading to the search for membership in a new and more satisfying group. After a period of exploration, and finding that they were not fully comfortable with either the mainstream American or ethnic culture, the narrators discovered the ethnic minority American group--Asian Americans. The narrators described their movement through these stages to achieve an Asian American identity as positive and self-validating. The paper concludes with a discussion of the implications of the findings for education and counseling.     

Hindsight bias in economic expectations: I knew all along what I want to hear

Hindsight bias in economic expectations was investigated with particular focus on the moderating effects of attitudes. Stronger hindsight bias was expected for subjectively favorable economic developments. Six months before and after the introduction of the euro as the official book currency of the European Monetary Union, participants rated the probabilities of several economic developments. Results show that hindsight bias occurs with economic expectations and that it is moderated by attitudes. Euro supporters showed stronger hindsight bias for positive economic developments than for negative ones, whereas euro opponents showed the opposite pattern. The results support the notion that hindsight bias is a reconstruction bias in which self-serving tendencies can influence the reconstruction selectively for favorable and unfavorable outcomes.     

Spiritual health locus of control and breast cancer beliefs among urban African American women.

The present study examined the relationship between spiritual health locus of control, breast cancer beliefs, and mammography utilization among a sample of 1,227 African American women from urban public health centers. Spiritual health locus of control was conceptualized as having an active and passive dimension, empowering individuals in their health beliefs and behaviors or rendering them to rely on a higher power (e.g., God) to determine their health outcomes, respectively. The active dimension was negatively associated with perceived benefits of mammography and positively associated with perceived barriers to mammography. The active and passive spiritual dimensions are distinct from internal and external health locus of control. Further study of their associations with other health-related beliefs and behaviors is warranted.     

Mental health care for Hispanic Americans: a current perspective

In this article, the authors review patterns and challenges in the conceptualization, implementation, and academic support of the mental health services of Hispanic Americans. A critical analysis was conducted on information obtained through manual and computerized searches of published literature and conference reports. New clinical care approaches include the DSM-IV's cultural formulation with its complement of standardized multiaxial diagnosis, integration of services across clinical disorders or conditions and across sources of care, as well as pluralistic criteria and judges for service outcome appraisal. Emerging clinical approaches offer an opportunity to enhance the mental health care of Hispanic Americans within an increasingly multicultural U.S. society.     

'If you don't want to tell anyone else you can tell her': young people's views on school counselling

The aim of the research was to assess the views of young people about school counselling. In total, 415 pupils from five secondary schools took part in the survey. A smaller number of these pupils took part in focus groups (n=9) to explore their views in more depth. In general, the young people seemed to value having a school counsellor. Most were aware of the school counselling service, although a substantial number (21%) indicated a lack of awareness. For many who were aware, their knowledge of the service was limited. Just over one third of the pupils stated that they would go to see the school counsellor, and girls were more likely to state this than boys. The confidentiality of the service was perceived to be one of the benefits. However, this was also reported to be a hindering factor—the concern that it may not, in fact, be confidential. Two other main reasons for not accessing the service were the counsellor being a stranger and (for boys in particular) a concern about other people finding out (associated with the social stigma of going for counselling). Suggestions to improve the school counselling service included a room in a discrete location, better promotion of the service, more counsellors or a full-time counsellor, and ways to get to know the counsellor better. Those responsible for developing and managing school counselling services should consider these suggestions.