Help-seeking behavior and attitude of Chinese Americans regarding psychological problems

Investigated the help-seeking behavior and attitude regarding psychological problems as mediated by mental health status, acculturation level, and sociodemographic characteristics in a community sample of Chinese Americans. Of the 128 respondents, 17 (13.3%) had consulted professional help for a nervous or emotional problem. Compared to the others, they reported significantly poorer mental health status (i.e., had more physical symptoms, had once come close to experiencing a "nervous breakdown," and had a relative who had been in treatment), and were more likely to be American-born. For those who had not previously sought help, attitude toward help seeking was examined. A positive attitude was mediated by superior English ability, being younger, married, and from a lower SES background. The findings suggested help-seeking behavior is primarily mediated by presence of need, whereas attitude reflected a general propensity. Acculturation was an important predictor of both behavior and attitude, with the less acculturated most in need of education about the utility of mental health service.     

Confusion and its dynamics during device comprehension with breakdown scenarios

The incidence and dynamics of confusion during complex learning and problem solving were investigated in an experiment where participants first read illustrated texts on everyday devices (e.g., an electric bell) followed by breakdown scenarios reflecting device malfunctions (e.g., “When a person rang the bell there was a short ding and then no sound was heard”). The breakdown scenarios were expected to trigger impasses and put participants in a state of cognitive disequilibrium where they would experience confusion and engage in effortful confusion resolution activities in order to restore equilibrium. The results confirmed that participants reported more confusion when presented with the breakdown scenarios compared to control scenarios that involved focusing on important device components in the absence of malfunctions. A second-by-second analysis of the dynamics of confusion yielded two characteristic trajectories that distinguished participants who partially resolved their confusion from those who remained confused. Participants who were successful in partial confusion resolution while processing the breakdowns outperformed their counterparts on knowledge assessments after controlling for scholastic aptitude, engagement, and frustration. This effect was amplified for those who were highly confused by the breakdowns. There was no direct breakdown vs. control effect on learning, but being actively engaged and partially resolving confusion during breakdown processing were positive predictors of increased learning with the breakdown compared to control scenarios. Implications of our findings for theories that highlight the role of impasses, cognitive disequilibrium, and confusion to learning are discussed.     

“Grasping the Grey”: Patient Understanding and Interpretation of an Intermediate Allele Predictive Test Result for Huntington Disease

Since the discovery of the genetic mutation underlying Huntington disease (HD) and the development of predictive testing, the genetics of HD has generally been described as straightforward; an individual receives either mutation-positive or negative predictive test results. However, in actuality, the genetics of HD is complex and a small proportion of individuals receive an unusual predictive test result called an intermediate allele (IA). Unlike mutation-positive or negative results, IAs confer uncertain clinical implications. While individuals with an IA will usually not develop HD, there remains an unknown risk for their children and future generations to develop the disorder. The purpose of this study was to explore how individuals understood and interpreted their IA result. Interviews were conducted with 29 individuals who received an IA result and 8 medical genetics service providers. Interviews were analyzed using the constant comparative method and the coding procedures of grounded theory. Many participants had difficulty “Grasping the Grey” (i.e. understanding and interpreting their IA results) and their family experience, beliefs, expectations, and genetic counseling influenced the degree of this struggle. The theoretical model developed informs clinical practice regarding IAs, ensuring that this unique subset of patients received appropriate education, support, and counseling.     

A multinomial logit analysis of methods used by persons who completed suicide

This paper presents a multinomial logit analysis of the methods used by Taiwanese individuals who completed suicide between 1991 and 1993. We investigated the influence of age, gender, urban or rural residence, seasons, and occupations on the six "choices" of suicide methods. The findings suggest that a systematic pattern exists between the choice of method and demographic characteristics of persons who have completed suicide. Most of the different patterns of suicide by sex, age, occupation, or residence can be understood by the different availability and accessibility to the means of suicide faced by the individuals. Our findings support Becker's (1962, 1974, 1993) contention that all kinds of human behavior or choices are shaped by the constraints imposed on the individuals. The findings also have important policy implications for suicide prevention in that they support Lester's advocacy to prevent or reduce suicide incidents by limiting availability, blocking accessibility, or "inconveniencing" the suicidal individuals.     

Perceptions of people who stutter: re-assessing the negative stereotype

A common finding of past research is that people who stutter are stereotyped as being more guarded, nervous, self-conscious, tense, sensitive, hesitant, introverted, and insecure than nonstutterers. Using an innovative survey method, two questions studied were (1) whether individuals who have on-going contact with the same stutterer share the negative stereotype identified by past research, and (2) whether there are differences in perceptions of speech fluency between stutterers and their listeners. Responses of 114 friends and colleagues of stutterers found those who had on-going contact with at least one stutterer have less stereotypical attitudes than the general population, and significant differences in perceptions about normalcy of speech were noted for people who stutter and those with whom they interact.     

On the Subjectivity of Lustful States of Mind

This paper explores certain subjective dimensions of sexuality by proposing that erotic experience is predicated on an experience of otherness within the self. I suggest that the ability to lust where one loves is contingent on the capacity to bring this otherness of self forward in the context of attachment. The dampening or deadening of desire in long-term relationships may be understood, counterintuitively, not as a failure of the integration of lust with love but as a breakdown of the normative dissociative processes on which the emergence of lust depends. I theorize that the otherness of lustful states of mind emerges via the impact and dynamic interplay of social regulatory intrusions on identity formation. This understanding helps explain both the psychic tensions and potential sources of breakdown present in combining lust with love.     

Acknowledgment of handicap as a tactic in social interaction

Nonhandicapped people often report discomfort and uncertainty when interacting with handicapped individuals. The three studies reported here investigated a possible tactic that handicapped people could use to reduce a fellow interactant's discomfort and uncertainty. Nonhandicapped subjects watched two videotapes of handicapped individuals being interviewed. Each subject then chose the handicapped person with whom he would prefer to work on a cooperative task. Results of all three studies supported the hypothesis that a handicapped person acknowledging his handicap will be preferred to a handicapped person who does not acknowledge his handicap. In Study 1, subjects significantly preferred a handicapped person who acknowledged his handicap to a handicapped person who did not disclose anything personal. In Study 2, subjects significantly preferred an acknowledging person over one who made a personal disclosure other than about his handicap. In Study 3, subjects preferred the individual acknowledging a handicap over one who disclosed something else personal even when the acknowledging individual was clearly nervous about doing so. These results suggest that acknowledging the handicap may be a promising tactic.     

Responses to nervous breakdowns in America over a 40-year period. Mental health policy implications

The 1957 and 1976 Americans View Their Mental Health surveys from the Institute of Social Research were partially replicated in the 1996 General Social Survey (GSS) to examine the policy implications of people's responses to feeling an impending nervous breakdown. Questions about problems in modern living were added to the GSS to provide a profile of the public's view of mental health problems. Results were compared for 1957, 1976, and 1996. In 1957, 19% of respondents had experienced an impending nervous breakdown; in 1996, 26% had had this experience. Between 1957 and 1996, participants increased their use of informal social supports, decreased their use of physicians, and increased their use of nonmedical mental health professionals. These findings support policies that strengthen informal support seeking and access to effective psychosocial treatments rather than current mental health reimbursement practices, which emphasize the role of primary care physicians.     

Medicalization and linguistic agency

Medicalization is the process by which conditions, for example, intellectual disability, hyperactivity in children, and posttraumatic stress disorder, become understood as medical disorders. During this process, the medical community often collectively assigns a label to a condition and consequently to those who would be said to have the disorder. We argue that there are at least two previously overlooked ways in which this linguistic practice may be wrongful, and sometimes, unjust: first, when the initial introduction of a medical label is done without the participation of those individuals who are being labelled, and second, when attempts by those individuals to renegotiate the labels are thwarted or otherwise rendered ineffective. In both cases, we argue, individuals are unfairly excluded from a linguistic practice that would be valuable for them to participate in. Furthermore, we argue that their exclusion depends in part on the authority of the medical institution to ignore their demands for participation. In making this case, we will propose the more general claim that participating in the linguistic processes of determining and renegotiating the words that will be used to describe oneself is an exercise of linguistic agency, a capacity that has both instrumental and intrinsic value.     

Psychopathy and the Five-factor model of personality: a replication and extension

It has recently been argued that psychopathy can be understood and represented using common dimensions of personality taken from the Five-factor model (FFM). In this research, we examined this possibility by using the Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) to assess psychopathy in an undergraduate sample. Specifically, we matched individuals' NEO-PI-R profiles with an expert-generated psychopathy prototype to yield a psychopathy score. These scores were correlated with self-reports of drug use, delinquency, risky sex, aggression, and several laboratory tasks. FFM psychopathy was significantly related to all forms of deviance, although the effects tended to be small in size. Moreover, individuals who more closely resembled the prototypic FFM psychopath were more aggressive in a laboratory aggression task, less willing to delay gratification in a time discounting task, and demonstrated a preference for aggressive responses in a social information-processing paradigm.     

The disintegrative factor in therapeutic groups as illuminated by kibbutz life

This article deals with the way individuals cope with the threat they experience in the framework of psychodynamic group psychotherapy. This threat, which is understood to be a disintegrative threat, is intensified in the therapeutic group. We see the therapeutic group as possessing attributes of a potential space, in which the participants are enabled to process the defense and coping mechanisms intended to preserve the sense of integration. This will be illustrated by the experiences of individuals who grew up in a kibbutz (an Israeli society in which infants were raised with their peer group) and participated in psychodynamic groups.     

Narratives of therapeutic art-making in the context of marital breakdown: older women reflect on a significant mid-life experience

This paper explores the narratives of three women aged 65–72 years. They reflected on an episode of therapeutic art-making in midlife, which addressed depression associated with marital crisis and breakdown. The narrative analysis focused upon on the ways in which participants narrated the events leading up to their participation in therapeutic art-making; the aspects of therapeutic art-making that continued to be given significance; the characters given primacy in the stories they told about their journey through therapy and marital breakdown; meanings, symbolic and otherwise, that participants ascribed to their artwork made during this turning point in their lives; and aspects of the narratives that conveyed present-day identities and artistic endeavors. The narratives revealed the complexity of the journey through marital breakdown and depression into health, and showed that therapeutic art-making could best be understood, not as a stand-alone experience, but as given meaning within the context of wider personal and social resources. Participants looked back on therapeutic art-making that occurred two decades earlier and still described this as a significant turning point in their personal development. Art as an adjunct to counselling/therapy was not only symbolically self-expressive but provided opportunity for decision-making, agency and a reformulated self-image.     

Forgetting unwanted memories: directed forgetting and thought suppression methods

Experimental psychopathologists have tested hypotheses regarding mechanisms that ought to be operative if victims possess skills for forgetting material related to trauma. In this article, we review research on directed forgetting and thought suppression paradigms, concentrating on laboratory studies involving attempts by individuals reporting trauma histories to forget emotionally negative material. Most studies have shown that trauma survivors, especially those with post-traumatic stress disorder, are characterized by a breakdown in the ability to forget disturbing material. Studies on individuals reporting repressed or recovered memories of trauma have not confirmed predictions regarding heightened forgetting skills for trauma-related words. However, recent research on suppressing disturbing autobiographical memories suggests that people who report spontaneously recalling childhood abuse outside of psychotherapy may, indeed, possess skills for not thinking about disturbing material.     

On feeling understood and feeling well: The role of interdependence

The present research examined whether people feel happier and healthier when they feel more understood in daily social interactions. A two-week diary study showed that people reported greater life satisfaction and fewer physical symptoms on days in which they felt more understood by others. Moreover, we found that individuals who tend to see themselves in relations to others (i.e., women or those scored high on interdependent self-construal measure) showed a stronger association between daily felt understanding and daily life satisfaction or physical symptoms. These findings demonstrate that daily social experiences, such as felt understanding, are associated with daily well-being, particularly for individuals with greater interdependent self-construal.     

Metaphor and the violent

During the treatment of violent individuals who were, incidentally, highly verbal, the authors noticed that physical assaults were often preceded by the perpetrator s use of metaphors. It was observed that the linguistic metaphors failed to function as ordinary as if devices and became concretised. When this occurred, the perpetrators resorted to a physical attack. In this paper, the authors argue that the capacity to interconnect (which is considered to be the essence of psychic work) is dependent upon what can be conceptualised as a primary mental frame or warp. Distortion of the warp will, in turn, weaken the weaving, or interconnecting function of the ego, which is considered analogous to the interconnecting in linguistic metaphors. Clinical material from the treatment of three violent men (two in psychotherapy and one in analysis) is used to illustrate the hypothesis that the concretised use of metaphor represents a restitutive, but failed attempt to maintain a psychic coherence in the face of an imminent breakdown.     

Within-person variability in response speed as an indicator of cognitive impairment in older adults

Within-person variability may be an important indicator of central nervous system compromise. In this study, within-person variability in response speed was examined in community-dwelling older adults, ages 64-92 years, using a new framework that takes into account both the extent (single versus multiple domains affected) and nature (amnestic versus non-amnestic) of the cognitive impairment. Those with multiple domains of impairment were more variable than those who showed an isolated area of impairment, regardless of whether memory was one of the domains affected. Further, for those with difficulties in two or more non-memory domains, increased variability was most evident in more cognitively demanding situations, when individuals had to manipulate information held briefly in mind, switch cognitive set or inhibit an automatic response. Finally, group differentiation was better achieved when within-person variability as opposed to mean speed of performance was considered.     

Noun and verb processing in Greek-English bilingual individuals with anomic aphasia and the effect of instrumentality and verb-noun name relation

Noun and verb comprehension and production was investigated in two groups of late bilingual, Greek-English speakers: individuals with anomic aphasia and a control group of non-brain injured individuals matched for age and gender. There were no significant differences in verb or noun comprehension between the two groups in either language. However, verb and noun production during picture naming was significantly worse in the bilingual individuals with anomic aphasia in both languages, who also showed a specific verb impairment in Greek and English. The potential underlying level of breakdown of the specific verb impairment was further investigation with reference to two specific features of verbs: instrumentality and verb-noun relationship. Additional results revealed a facilitatory effect of Instrumentality in both languages. However, there was no effect of verb-noun name relation in Greek, and a negative effect of verb-noun name relation was observed in English. Lemma retrieval seemed to be intact in this group of bilingual individuals whose main problem seemed to arise during the retrieval of the phonological representation of the target word. This impairment was greater in English. The findings are discussed in terms of three current models of word production.     

Benefitting from a different perspective: The effect of a complementary matching of psychological distance and habitual perspective on emotion regulation

Psychological distance in terms of its purpose as a psychological adjustment is currently not well understood. Some researchers claim that psychological distance serves as an emotion regulator, while others argue that psychological distance has the reverse effect, leading to cognitive avoidance and rumination. To elucidate upon this discrepancy, we propose that a complementary matching of psychological distance to one's habitual psychological distance perspective may lead to better emotion regulation when compared to the original perspective (i.e. fixing on either psychological immersion or distance). This study hypothesizes that a complementary matching of psychological distance to one's habitual perspective generally leads to better emotion regulation; specifically, individuals with high avoidant attachment, who habitually distance themselves from their experiences, may benefit from psychological immersion, while individuals with high anxious attachment, who habitually immerse themselves in their experiences, may benefit from psychological distancing. A total of 83 participants completed measures of adult attachment orientations; read a conflict scenario, triggering their attachment systems; and then rewrote that scenario using designated pronouns, thereby employing psychological immersion or psychological distance. Participants in the self‐immersed condition were asked to write from the first‐person perspective, whereas those in the self‐distancing condition were asked to write from the third‐person perspective. The results support our hypothesis of a complementary matching of psychological distance and habitual perspective.     

The reported prevalence of mandated community treatment in two Florida samples

Questions on multiple modes of mandated community treatment (e.g. outpatient commitment, advance directive, representative payee, and special housing) were included in two studies of persons with mental illness, using a mail survey of Medicaid enrollees receiving SSI and interviews conducted as part of an evaluation of a specialty mental health court. Results indicate that the majority of individuals reported no experience with any forms of mandated community treatment. However, respondents from the two samples who had been subject to community mandates reported comparatively similar experiences. Additional studies of the prevalence of mandated community treatment are necessary to garner expanded information regarding the use of such mandates. In addition, future studies must assure that the language employed to query individuals regarding such mandates is clearly understood by respondents, as certain terms (e.g. "outpatient commitment") may mean different things to different respondents.     

The Geometry of the Eternal Triangle

Jealousy is often imputed to psychopathology in the protagonist. Psychodynamically, it can be attributed to an ego-deficiency, chronic insecurity, or a deflected libidinal drive. We propose that, when a primary love relationship is threatened, jealousy is best understood from a systems perspective. Three individuals create the experience of jealousy in one of them, which results in a pathogenic "eternal triangle" composed of: the jealous partner who seeks to woo and/or punish an errant mate; the architect of the triangle who takes a lover to supplement the marriage or supplant the mate; and a third person who intrudes across the boundaries of the couple. Therapists must be aware of the role of each agent in order to deal with the volatile, yet highly enduring configuration of the triangle.