Benefits of belonging: Experimental manipulation of social inclusion to enhance psychological and physiological health parameters

Objective: Acute changes in social belonging are important triggers for alterations in health and well-being, yet research has emphasised the negative effects of ‘exclusion’ at the expense of evaluating the potentially positive effects of ‘inclusion’. This study examined the impact of acute belonging on physiological and psychological outcomes.

Design and main outcome measures: A healthy population (N?=?138) were randomly allocated to ‘included’ or ‘excluded’ conditions. Condition-dependent differences in pre/during-task heart rate and pre/post-task self-reports of negative/positive mood, and social self-esteem, were assessed.

Results: Included participants showed decreased heart rate and negative mood, and increased social self-esteem. No inclusion-related change in positive mood was shown. An increase in heart rate was observed in excluded participants though no changes in negative/positive mood or social self-esteem were shown. Shifts in social self-esteem acted as a mechanism through which inclusion/exclusion impacted upon negative and positive mood alterations. Results remained significant in presence of covariates (sex, global self-esteem, rumination and social anxiety).

Conclusion: Findings suggest that acting to enhance belonging through ‘inclusion’ resulted in adaptive physiological and psychological outcomes. Neutral and potentially protective responses were observed in the immediate aftermath of ‘exclusion’. Self-esteem served as one route through which these effects were transmitted.     

A qualitative analysis of the vaccine intention–behaviour relationship: parents’ descriptions of their intentions,decision-making behaviour and planning processes towards HPV vaccination

Objective: The objective of this study is to identify factors influencing the vaccine intention–behaviour relationship. Design: A total of 445 parents who received a brief intervention to promote HPV vaccination were categorized based on their intentions post-intervention (yes/unsure/eventually/never) and subsequent adolescents’ vaccine status (yes/no). Fifty-one of these parents participated in qualitative interviews. Main Outcome Measures: Parents described their intentions, decision-making and planning processes towards vaccination. Framework analysis was used to analyse the data. Results: Parents in the ‘Yes/Yes’ category were knowledgeable about HPV/vaccine, described strong, stable intentions, considered themselves the primary decision-makers about vaccination and said they vaccinated immediately. ‘Yes/No’ parents described strong intentions and thought their adolescent was vaccinated OR described hesitant intentions, seeking advice/agreement from others and noting barriers to vaccination without solutions. ‘Unsure/Yes’ parents described their intentions as strengthening with information from credible sources and identified strategies for overcoming barriers. ‘Unsure/No’ and ‘Eventually/No’ parents had misinformation/negative beliefs regarding vaccination, described being ambivalent or non-supportive of vaccination and cited barriers to vaccination. ‘Never/No’ parents held negative beliefs about vaccination, described strong, stable intentions to NOT vaccinate, deferring the decision to others, and reported no planning towards vaccination. Conclusions: Intention characteristics and planning processes could moderate the vaccine intention–behaviour relationship, potentially serving as targets for future vaccine strategies.     

‘Damned one way or another’: Bariatric surgeons’ reflections on patients’ suboptimal outcomes from weight loss surgery

Objective: A minority of patients show sub-optimal outcomes after weight loss surgery. Research has identified predictors of poor outcomes focusing on the patients’ perspective. No research has explored surgeons’ accounts. Design: Ten Bariatric surgeons were interviewed using a critical incident approach to explore their explanations for sub-optimal outcomes in the context of a real-life case. Data were analysed using thematic analysis. Results: Three main themes were developed: ‘Challenges to success’ highlighting the role of psychosocial issues, poor adherence and patient non-disclosure; ‘Ideal world solutions’ describing who should identify and address psychosocial issues; and ‘Real world compromise’ reflecting the impact of limited resources and weighing up risk between carrying out versus not carrying out surgery. Transcending these themes was the notion of ‘responsibility’ with surgeons balancing the role of the patient, themselves and the health care system. Conclusion: Some surgeons concluded that if they had known before surgery what they know now, they may not have operated. All emphasised that they could only know what was disclosed by the patient, that they were not convinced that not operating would have resulted in better outcomes in the longer term and many felt that they were ‘damned one way or the other’.     

Understanding behavioural clusters: Identifying differences between clusters of health behaviours on key constructs

Objective: To uncover the rationale underlying the perceived distinction between clusters of health behaviours by identifying cognitive constructs that differentiate among them, and creating a ‘cognitive profile’ for each behavioural cluster. Thus, different determinants and characteristics of health behaviours (e.g. ‘perceived behavioural control’, ‘impact on health’, ‘effort’, ‘non-health rewards’, ‘habit’) were used to compare health behaviour meta-clusters (physical and psychosocial) and clusters (e.g. nutrition behaviours, substance abuse, medical practices).

Methods: A sample of lay people (N = 1956) judged items representing behavioural clusters delineated in the Health Behaviour Taxonomy on 14 constructs.

Results: Significant differences emerged between the physical and psychosocial meta-clusters, as well as among their sub-clusters. For example, physical behaviours were higher on ‘perceived behavioural control’ and ‘impact on health’ compared to psychosocial behaviours, and nutrition was perceived highest on ‘effort’ and ‘non-health rewards’ compared to the other clusters of the physical meta-cluster.

Conclusion: The findings increase our understanding of the logic underlying lay people’s cognitive schema of health behaviour clusters. ‘Cognitive profiles’ that explain differences between the clusters were identified, which can be used to design health messages and interventions targeting multiple health behaviours.     

Primary school teacher outcomes from online professional development for physical literacy: A randomised controlled trial

IntroductionPrimary (or elementary) school teachers are often relied upon to provide children with opportunities for physical literacy development; however, many of these teachers feel they lack the skills to effectively promote or ‘teach’ physical literacy. We examined the effects of an online physical literacy professional development program—relative to receiving widely-available online resources or continuing with ‘normal’ practice—on primary school teachers’ physical literacy knowledge and application.MethodsA parallel three-arm randomised controlled trial in which 92 primary school teachers were assigned to (a) an online professional development program designed to support teachers’ physical literacy instructional skills (‘intervention’), (b) receive widely-available online physical literacy resources (‘comparison’), or (c) a typical practice ‘control’ condition. Data were collected at baseline and following the four-week intervention period. The primary outcome was teachers’ physical literacy knowledge and application; secondary outcomes included teachers’ self-reported perceptions of confidence, values, and barriers. Between-group differences were assessed using the intention-to-treat principle with analysis of covariance accounting for demographic factors and baseline differences in the focal outcome.ResultsTeachers in the intervention arm scored significantly higher on post-intervention physical literacy knowledge and application than their counterparts in both the control (d = .47, p = .044) and comparison (d = 0.87, p = .007) arms. This pattern of differences was also observed for teachers’ value of physical literacy, autonomy support, and perceived personal barriers.ConclusionTo the best of our knowledge, this is the first adequately powered randomised controlled trial to demonstrate improvements in physical literacy instructional outcomes as a result of primary school teacher participation in targeted online professional development.     

Beyond the politics of positionality: deconstruction and feminism

Abstract

The article commences with a discussion of Derrida's alleged anti-feminist position. We argue that, given his distinction between ‘reactive’ and ‘maverick’ feminism, this is an over-simplification. A correlation is drawn between the latter form of feminism and deconstruction by showing that both maintain a relation to the ‘beyond’ of the established logocentric system. The second section of the article deals with the placing of woman in Derrida's Spurs. It is shown that Derrida affirms Nietzsche's idea of the ‘Dionysiac woman’ who is, like the maverick feminist, not totally determined within the phallogocentric system. Woman, in Derrida's reading, becomes that which is not fully determinable. We conclude that this undecidability, rather than hindering its political activity, helps feminism in dealing with the diversities within the movement.     

Richard Wagner and the Birth of The Birth of Tragedy 1

Abstract

Nietzsche writes that the ‘real task’ of The Birth of Tragedy is to ‘solve the puzzle of Wagner’s relation to Greek tragedy’. The ‘puzzle’, I suggest, is the intermingling in his art and writings of earlier socialist optimism with later Schopenhauerian pessimism. According to the former the function of the ‘rebirth of Greek tragedy’ in the ‘collective artwork’ is to ‘collect’, and so create, community. According to the second the function of the artwork is to intimate a realm ‘beyond’ this world of pain and death. The audacity of The Birth is that it attempts to show that Wagner can have his cake and eat it: the ‘Dionysian’, musical, element provides a ‘metaphysical comfort’, while the ‘Apollonian’, verbal, element draws a ‘veil of oblivion’ over the metaphysical, thereby allowing the artwork to solidify community. Contrary to the standard Anglophone view, this perspective on The Birth shows that Nietzsche’s intimate association with Wagner during the period of its creation lies at the heart of its philosophical content.     

Post,Oblique, Human

Abstract

Taking its cue from the oblique of Elaine L. Graham's ‘post/human’, this essay examines the difficult relationship between humanism and its ‘post’. If, as Graham points out, the present moment is one in which anthropocentrism is both in crisis and deferred to as ‘common sense’, what is to be done? Perhaps the answer lies in strategies for ‘obliquing’ humanist discourse, working through its contradictions in order to establish the ‘post/human’ as a figure that forever disrupts humanism.     

Dissociation,the true self and the notion of the frozen baby

Abstract

The widespread ‘trauma talk’ that is prevalent in the social sciences, has, in recent years, become increasingly commonplace in psychoanalytic writings, especially in attachment theory and relational psychoanalysis. This paper examines dissociation, a key concept in ‘trauma theory’, in conjunction with the Winnicottian term ‘true self’, in the context of a particular discursive and theoretical combination of the two. This discursive formation is named ‘the frozen baby discourse’, and it is presented and analysed. A critique is offered of the way ‘true self’, understood as a humanistic concept, is often used together with dissociation, in order to create a theoretical construct that is far removed from Winnicottian theory. This paper begins by exploring definitional issues, both around dissociation and ‘true self’. It is subsequently argued that this contemporary usage of ‘true self’ in combination with dissociation has important implications for psychoanalytic practice.     

Negotiating ending: A qualitative study of the process of ending psychotherapy

Objectives: When psychotherapy is open-ended, the question of termination is a matter for negotiation. A model based on both content and the process of ending may explain how ‘good enough’ psychotherapies can be brought to ‘good enough’ endings.

Design: Twelve processes of ending were explored through a combination of audio recordings made during therapy sessions and post-therapy interviews with clients and therapists. Therapies had been tailored to the needs of the clients and were based on a broad spectrum of theoretical affiliations.

Methods: A procedure for systematic text condensation was used on a case-by-case basis. Issues surrounding the initiation and negotiation of ending were pointed out in each case and were then compared across cases.

Results: The initiation of ending and exchanges concerned with when and how to end therapy unfolded as a concerted process because both parties seemed to be aware that the theme of ending contained a potential challenge to the alliance. Dual affect regulation, implicit communication and a future-oriented perspective were important features. Structural elements such as schedule changes and temporary breaks served several psychological functions. Therapies seemed to reach ‘good enough’ endings when the client and therapist joined in their efforts to resolve basic ambivalences embedded in the decision to terminate contact with the affirmation of a continuing emotional bond.     

Para athlete activism: A qualitative examination of disability activism through Paralympic sport in Ireland

ObjectivesLittle attention has been given to how Para athletes use their platforms for disability activism. This paper fills this gap by examining how Irish Para athletes take actions to create social change around disability.MethodsA qualitative methodology was adopted. 28 elite-level Irish Para athletes were recruited and participated in interviews. The data set was analysed using a reflexive thematic analysis.ResultsThree themes: ‘Para athlete activisms’ captures different ways of doing disability activism; ‘tensions between different activist identities’ concerns (hyper)critical discourses about various activist identities; ‘ableist influences on Para sport culture’ captures contexts that enable or prevent performing disability activism.ConclusionsThe central theoretical contribution is an interpretation of Para athlete activism in terms of a contextually informed continuum of behaviour change. This article is an evidence base for Para sport cultures that wish to connect with disability activism. Practical opportunities are discussed around the psychology of adversity, social legacy value, identity politics and challenging ableism.     

When does ‘Can’ imply ‘Ought’?

ABSTRACT

The Assistance Principle is common currency to a wide range of moral theories. Roughly, this principle states: if you can fulfil important interests, at not too high a cost, then you have a moral duty to do so. I argue that, in determining whether the ‘not too high a cost’ clause of this principle is met, we must consider three distinct costs: ‘agent-relative costs’, ‘recipient-relative costs’ and ‘ideal-relative costs’.     

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban

Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban.

Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers.

Main outcome measures: Intention to quit, quit attempts and ‘rejecting’, ‘victimizing’, ‘socially conscious smoking’ and ‘active quitting’ responses to the smoking ban.

Results: Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES.

Conclusion: Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.     

The effects of scenario-based risk information on perceptions of susceptibility to Chlamydia and HIV

Abstract

Objectives: The Self-Report Habit Index (SRHI) was originally reported as one-dimensional; however, habit has been described as characterised by several features. Moreover, one-dimensional models for the SRHI have demonstrated poor fit. Therefore, we aimed to compare multidimensional models with a one-dimensional model in both snacking and physical activity habits, besides examining further instrument characteristics.

Design: A cross-sectional study was conducted with high school and university students (n?=?555).

Main outcome measure: The SRHI adapted for physical activity and for snaking habits was applied at one time point.

Results: Nested models with one factor, two factors and three factors were compared. Next, a hierarchical second-order model was tested, and further validity issues, as well as invariance between habits, were examined. Three-dimensional models represented a better fit for both habits. However, fit was still inadequate in the snacking version. In addition, discriminant validity concerns emerged for the physical activity SRHI. Moreover, invariance between the snacking and the physical activity versions was not confirmed.

Conclusions: Considering the SRHI as composed by the dimensions of ‘lack of awareness’, ‘lack of control’ and ‘history of behavioural repetition’ seems to be more accurate. Nevertheless, our findings suggest that further research is needed.     

Addicts to artists: The ‘good enough mother’ in the substance abuse clinic

Psychodynamic psychotherapy has had a bad reputation in substance abuse circles. Despite widespread use of behavioral interventions, outcomes remain relatively poor. The emerging trend is to incorporate relational and other psychodynamic approaches into addiction treatment. The article describes use of Winnicott's concepts of the ‘good enough mother’ and ‘play space’ in an outpatient ‘art group’.     

Translating Islam into the language of the Russian state and the Orthodox Church

ABSTRACT

This contribution analyses the discursive strategies exercised by Russia’s state-appointed Islamic authorities. It draws on a linguistic corpus that consists of speeches and sermons by Mufti Ravil’ Gainutdin, the head of a major Muslim Spiritual Directorate in Moscow. A multi-levelled analysis shows that the mufti’s lexical and rhetorical choices correspond to the discourse of the Russian Orthodox Church elites. This affinity is a discursive strategy that allows Gainutdin to position himself as the authoritative leader of Russia’s Islamic community and to construct Islam as Russia’s ‘familiar’ and ‘traditional’ religion.     

The impact of valence framing on response expectancies of side effects and subsequent experiences: a randomised controlled trial

Abstract

Objective: Pre-treatment side effect expectancies often influence subsequent experiences; however, expectancy-based reduction strategies are lacking. We explored whether framing information about adverse responses (in positive or negative formats) altered expectancies and experiences of a cold pressor task. We further investigated associations between expectancies and experiences, to inform potential interventions.

Design: Healthy volunteers (N?=?134), randomised to receive positively- or negatively-framed pre-cold pressor task information, self-rated 12 expectancies for cold pressor experiences, emotional state and coping style.

Main Outcome Measures: Self-reports of the same 12-experiences (recorded during and after the experiment) were assessed.

Results: Framing had minimal impact on expectancies and experiences; however, discomfort threshold (p?=?.08, d?=?0.22) showed a trend in the expected direction. Hierarchical regressions revealed expectancies uniquely, significantly predicted 6–23% of the variance for 11 subsequent experiences. Following a popular charity event (Ice Bucket Challenge), all participants showed higher ‘discomfort thresholds’ (p?=?.001, d?=?0.59), and those in the negative frame reported more overall ‘discomfort’ (p?=?.01, d?=?0.60) than participants in the positive condition.

Conclusion: Expectancies uniquely influenced subsequent cold pressor experiences. Framing had minimal impact in this ‘analogue’ medical setting, only influencing ‘discomfort threshold’. ‘Discomfort threshold’ and overall ‘discomfort’ were also impacted by a social media challenge, highlighting a potential area for intervention.     

Intermingling and confusion

Abstract

An understanding of Descartes’ concept of ‘confusion’ is important both for making sense of his epistemological enterprise and for grasping his doctrine of the union of mind and body. An analysis of Descartes’ notion of confusion is offered which is grounded in the (more or less controversial) theses that confused thoughts are thoughts, that confusion is confusion by a thinker of one thought with another, and that confusion both can and should be avoided or ‘undone’. This analysis takes its rise from his contrast between ‘confused’ and ‘distinct’ : it exhibits confusion as a failure to distinguish between meanings of systematically ambiguous expressions. This failure is sometimes due to ‘bad intellectual habits’ which in his view ought to be broken, sometimes to ‘nature’ (where the confusion is in general beneficial to our welfare). Paradigmatically these are expressions which refer ambiguously to substances (i.e. mind and body) which are ‘really distinct’. Moreover, his ‘disambiguations’ indicate a central but neglected aspect of his aim in philosophizing: he can be seen as engaged in a moral project of ‘philosophical therapy’.     

Some Issues with ‘Some Issues in Human Sexuality’

Abstract

In December 2003 the House of Bishops' Group on Issues in Human Sexuality published their ‘discussion document’, Some Issues in Human Sexuality: A Guide to the Debate (London: Church House Publishing, 2003). The document is a guide to the theological debate on questions that have arisen in response to the 1991 House of Bishops report, Issues in Human Sexuality (see p. ix). This article is a contribution to the discussion. I first question whether the document is a ‘guide’ and whether the quarrels between Anglicans are best designated a ‘debate’. Then within the limits of a single article I illustrate from the first three chapters grave problems of omission, of biblical interpretation, and of ethical development.     

On Husserl's Essentialism

Abstract

The present paper argues that Merleau-Ponty’s notion of Flesh/reversibility intellectually is significantly flawed, and leads phenomenology into something of a dead end. This is shown through the following strategy. First Merleau-Ponty’s account of originary perception and his critique of the reflective attitude are expounded. They are shown to culminate in rejection of the subject-object relation as an ontological fundamental in favour of a ‘hyper-reflective method’. A critique of Merleau-Ponty’s position is then offered. It argues that originary perception is not logically prior to reflective thought, and that Merleau-Ponty fails to do justice to the scope of the subject-object relation. Specifically, he overlooks the way in which the relation is the basis of our practical perceptual orientation. It is then shown how this relation actually pervades Merleau-Ponty’s own all-important ‘hyper-reflective’ alternative – the notion of ‘Flesh’. Possible counter-arguments are considered and refuted. The need for a post-analytic phenomenology is posited.