Barriers to Mental Health Care: A 25‐Year Follow‐Up Study of the Orthodox Jewish Community

The current study is a 25‐year follow‐up to a mental health needs assessment in the often overlooked, but rapidly growing, Orthodox Jewish denomination. Results suggest increased acceptance of mental illness and its treatment and satisfaction with quality of care, along with decreased mistrust of the mental health field, belief that religion and psychiatry conflict, and tendency to attach stigmas to psychiatric problems. However, issues of stigma and affordability continue to be obstacles to treatment. El presente estudio es un seguimiento tras 25 años de una evaluación de necesidades de salud mental en la población frecuentemente ignorada, pero en crecimiento rápido, de individuos de denominación judía ortodoxa. Los resultados sugieren una mayor aceptación de enfermedades mentales y sus tratamientos, así como la satisfacción con la calidad de los cuidados, además de una reducción en la desconfianza hacia el campo de la salud mental, la creencia de que existe un conflicto entre religión y psiquiatría, y la tendencia a estigmatizar los problemas psiquiátricos. Sin embargo, problemas relacionados con la asequibilidad y el estigma continúan siendo obstáculos para el tratamiento.     

Satisfaction and Stressors in a Religious Minority: A National Study of Orthodox Jewish Marriage

The paucity of mental health studies with Orthodox Jews makes culturally competent counseling care unlikely. In this large‐scale investigation of marriage among Orthodox Jews, most respondents reported satisfaction with marriage and spouse, although satisfaction was highest among recently married couples. The most significant stressors were finances, communication, physical intimacy/sexuality, time pressures, and in‐law conflicts. Counseling interventions are discussed. La escasez de estudios sobre salud mental en poblaciones de judíos ortodoxos limita la posibilidad de ofrecer un cuidado de consejería culturalmente competente. En esta investigación a gran escala sobre el matrimonio entre judíos ortodoxos, la mayoría de los participantes indicaron satisfacción con su matrimonio y esposo/a, aunque la satisfacción fue mayor entre las parejas recién casadas. Los elementos estresantes más significativos fueron las finanzas, la comunicación, el contacto íntimo/sexualidad, la falta de tiempo, y los conflictos con la familia política. Se discuten intervenciones para la consejería.     

A Comparative Study of the Intelligence of Jewish Preschool Boys and Girls of Orthodox Parentage

Children aged 2-51/2 to 5-1/2 were pretrained on two three-choice simple discrimination problems presented consecutively, which were followed by training on 10 unique oddity sets. Transfer data were obtained from those Ss who learned the oddity problems by presenting five new oddity sets.

All three Groups learned the second pretraining problem more quickly than the first, although on both problems the two older Groups learned faster than the youngest Group. Nearly all the Ss learned to select the correct stimuli on the 10 three-choice oddity sets. Sixty-four percent of the children between 2-1/2 and 4-1/2 evidenced transfer to the five new oddity sets, indicating comprehension of the oddity relationship and the ability to respond on the basis of this higher-order solution. This finding is contrary to that predicted by contemporary theories of cognitive development (e.g., 3, 8).

The remaining Ss had either learned to choose the odd stimulus, but were unable to maintain a relational choice when presented with new sets, or solved the original discrimination by applying specific solutions to a 10-problem simultaneous three-choice discrimination problem.     

Socioeconomic Differences in Psychosocial Factors Contributing to Coronary Heart Disease: A Review

Psychosocial factors have been shown to play an important role in the aetiology of coronary heart disease (CHD). A strong association between CHD and socioeconomic status (lower-level education, poor financial situation) has also been well established. Socioeconomic differences may thus also have an effect on psychosocial risk factors associated with CHD, and socioeconomic disadvantage may negatively affect the later prognosis and quality of life of cardiac patients. The aim of this study was to review the available evidence on socioeconomic differences in psychosocial factors which specifically contribute to CHD. A computer-aided search of the Medline and PsycINFO databases resulted in 301 articles in English published between 1994 and 2007. A comprehensive screening process identified 12 empirical studies which described the socioeconomic differences in CHD risk factors. A review of these studies showed that socioeconomic status (educational grade, occupation or income) was adversely associated with psychosocial factors linked to CHD. This association was evident in the case of hostility and depression. Available studies also showed a similar trend with respect to social support, perception of health and lack of optimism. Less consistent were the results related to anger and perceived stress levels. Socioeconomic disadvantage seems to be an important element influencing the psychosocial factors related to CHD, thus, a more comprehensive clarification of associations between these factors might be useful. More studies are needed, focused not only on well-known risk factors such as depression and hostility, but also on some lesser known psychosocial factors such as Type D and vital exhaustion and their role in CHD.     

Environmental Factors Contributing to Wrongdoing in Medicine: A Criterion-Based Review of Studies and Cases

In this article we describe our approach to understanding wrongdoing in medical research and practice, which involves the statistical analysis of coded data from a large set of published cases. We focus on understanding the environmental factors that predict the kind and the severity of wrongdoing in medicine. Through review of empirical and theoretical literature, consultation with experts, the application of criminological theory, and ongoing analysis of our first 60 cases, we hypothesize that 10 contextual features of the medical environment (including financial rewards, oversight failures, and patients belonging to vulnerable groups) may contribute to professional wrongdoing. We define each variable, examine data supporting our hypothesis, and present a brief case synopsis from our study that illustrates the potential influence of the variable. Finally, we discuss limitations of the resulting framework and directions for future research.     

A Cross-Cultural Comparison of Gender Factors Contributing to Long-Term Marital Satisfaction

Abstract

This article reports on the major findings of a cross-cultural study comparing long-term marital satisfaction between Caucasian couples and Chinese couples in Canada. The Dyadic Adjustment Scale was used to screen couples' marital satisfaction. In-depth qualitative interviews were conducted individually and jointly with the screened couples to explore their meanings and experiences of marital satisfaction. With the use of narrative analysis, the study illuminates how couples constructed their gender relationships to achieve marital satisfaction over a long course of thirty to thirty-six years according to their sociocultural contexts. The similarities and differences in how the two cultural groups' respondents constructed their long-term marital satisfaction are discussed in terms of: (1) household division of labour, (2) decision-making, (3) conflict and compromise, and (4) mutuality.     

Challenges of Pre- and Post-Test Counseling for Orthodox Jewish Individuals in the Premarital Phase

The Jewish community has traditionally taken ownership of its health, and has taken great strides to raise awareness about genetic issues that affect the community, such as Tay-Sachs disease and Hereditary Breast and Ovarian Cancer syndrome. Thanks in part to these heightened awareness efforts, many Orthodox Jewish individuals are now using genetics services as they begin to plan their families. Due to unique cultural and religious beliefs and perceptions, the Orthodox Jewish patients who seek genetic counseling face many barriers to a successful counseling session, and often seek the guidance of programs such as the Program for Jewish Genetic Health (PJGH). In this article, we present clinical vignettes from the PJGH’s clinical affiliate, the Reproductive Genetics practice at the Montefiore Medical Center. These cases highlight unique features of contemporary premarital counseling and screening within the Orthodox Jewish Community, including concerns surrounding stigma, disclosure, “marriageability,” the use of reproductive technologies, and the desire to include a third party in decision making. Our vignettes demonstrate the importance of culturally-sensitive counseling. We provide strategies and points to consider when addressing the challenges of pre- and post-test counseling as it relates to genetic testing in this population.     

Moving Beyond the Illness: Factors Contributing to Gaining and Maintaining Employment

The work presented here, exploratory in nature, uses a comparative and qualitative approach to understand the factors associated with the ability of individuals with severe and persistent mental illness to successfully gain and maintain employment. Based on open-ended interviews with individuals in an Assertive Community Treatment (ACT) program, we compare the experiences of those who have been successful gaining and maintaining employment, with those who have been successful gaining but not maintaining work, and those who have been unsuccessful gaining employment. The three groups seemed to differ in three significant ways: (1) in the ways the individuals talked about their illness, (2) in the ways the individuals talked about work, and (3) in the strategies they described for coping with bad days. In each of these areas individuals' awareness of and attitude toward their illness was significant. The findings have clear implications for agencies working to help people with severe and persistent mental illness obtain and maintain employment.     

The Philanthropy of the Orthodox Church: A Rumanian Case Study

On the basis of a definition of God as "love", human philanthropyis derived from Divine philanthropy, and therefore extends toall human beings. Because Divine philanthropy is most centrallyexpressed in Christ's incarnation and resurrection, Christ'sidentification with all who suffer presents the strongest motivationfor human philanthropy. After a short review of the RomanianOrthodox Church's development after 1989, the author turns tohis special case study, the Social-Medical Day-Care ChristianCentre for older citizens. He describes the wan in which Church-basedphilanthropy can integrate socialmedical with Christian pastoralcare, and how this work draws the local communities into assuminga shared responsibility.     

Cognitive and Non-Cognitive Factors Contributing to the Longitudinal Identification of Successful Older Adults in the Betula Study

ABSTRACT

Studies of successful aging have typically defined elderly who fall in the upper end of a distribution of test scores as successful. A different definition of successful aging requires that older adults fall at or above the mean level of younger adults and maintain this level over time. Here we examined this definition of successful aging in a sample of 1463 individuals between the ages of 50 of 85. Based on principal coordinate analysis of cognitive and non-cognitive variables, we identified a group of 55 (8.3%) 70–85 years olds that were high functioning. This group of elderly showed elevated performance on a range of cognitive tasks. Non-cognitive factors that characterized this group included education and subjective health. The participants were retested 5 years later and the same type of analysis was repeated. Of the remaining individuals who initially were classified as high functioning, 18 (35%) remained high functioning and thus met the definition for successful aging. Years of education was a significant predictor of who remained successful over time.     

Assessing and treating sexual dysfunctions in Orthodox Jewish couples: a summary of 41 consecutive cases

ABSTRACT

Orthodox Jews are a distinct subgroup with specific beliefs and values towards sexuality, reproduction, modesty, and openness to mental health treatment. This paper reviews the treatment of 41 Orthodox Jewish couples who presented for sex therapy. Most couples were referred by a rabbinical leader. The most common presenting problem was an unconsummated relationship; present in 27 couples. In 34 couples the initial presenting complaint was a male sexual problem yet in 20 of 41 couples both partners described having some sexual problem. Almost 50 per cent of both men and women were also diagnosed with a comorbid psychiatric disorder, which was almost always previously undiagnosed. The most common presenting problems were vaginismus, male inhibited arousal, and/or inhibited male orgasm. Two case examples illustrate some adaptations to assessment and treatment that can be helpful in treating sexual problems in Orthodox Jewish couples.     

从犹太教到儒教:开封犹太人同化的内在因素之研究

历史上的开封犹太人问题一直是学术界所关注的话题。国内外学者充分地肯定其外在环境与外来影响,而恰恰忽略了从犹太人自身的角度探讨其内在的、也是最主要的因素。本文认为,开封犹太人同化的最根本动力来自犹太社团内部思想观念上的转变,即犹太人对犹太教信仰的逐步淡化和对儒教的深层次认同,犹太教的儒化过程正是开封犹太人的同化过程。文章试图以儒家思想所造就的文化氛围为宏观背景,探讨犹太教与儒教的文化交往与涵化,分析开封犹太人认同儒教的种种表象以及形成这些表象的原因。     

Dialectical Behavior Therapy Group Skills Training in a Community Mental Health Setting: A Pilot Study

Abstract

Effective and affordable therapies are needed for treating people with severe and persistent mental illness in a community mental health setting. In this pilot study, we evaluated the effectiveness of a modified dialectical behavior therapy (DBT) protocol for improving symptoms and functioning in a cohort of persons with severe and persistent mental illness. We provided six months of weekly DBT skills training in a group setting. Depression symptoms decreased significantly after treatment. There was a wide range of number of sessions attended, with a minority of the participants completing the full course of treatment. Increased attendance was correlated with improvements in depression symptoms, overall symptoms, quality of life, and community functioning. The study findings suggest that the group skills training component of DBT can be successfully implemented in a community mental health center and that further research to determine its efficacy in comparison to other treatments is warranted.     

A Pilot Study Implementing Coping Power in Italian Community Hospitals: Effect of Therapist Attachment Style on Outcomes in Children

The study presented the initial report of a project regarding the implementation of the Coping Power Program in Italian community hospitals, and the program’s ability to reduce externalizing behavioral problems in children with a Disruptive Behavior Disorder diagnosis. Usually, interventions for children are implemented by a number of therapists with different personal characteristics, which therefore influence the implementation quality of an intervention. That said, the present study aimed to establish whether the insecure attachment styles of therapists predict unfavorable outcomes for children treated with the Coping Power Program. The sample included 80 children with a Disruptive Behavior Disorder diagnosis and 16 therapists. The results showed that the change in children’s aggressive behavioral problems was significantly related to the levels of the therapist’s preoccupation with relationships. Higher levels of change in aggression (where a higher value means that the aggression at the end of the treatment is higher than aggression at the baseline evaluation) are associated with higher levels of therapist’s preoccupied attachment style (anxious attachment style). This study provided some preliminary evidence that therapists need to be sensitive to their own attachment experiences when delivering therapy for children.     

犹太哲学:一种命定的宗教哲学--评《现代犹太哲学》

如果有人说西方哲学里有一种“基督教哲学” ,那么没人会感到惊讶 ,但是 ,如果说有一种“犹太哲学” ,那么许多人即使不感到惊讶 ,也会觉得很陌生。当《现代犹太哲学》 (傅有德等著 ,人民出版社 ,1 999,1 2 )一书摆在笔者面前时 ,我多少就有这种感觉。犹太民族贡献给西方世界乃至全人类的最伟大财富是以《圣经·旧约》为核心的一神教信仰。作为一种文明看 ,这种一神教信仰与古希腊文明的不同就在于 ,前者强调的是在践行神圣律法这种活生生的信仰实践中去领会上帝存在的真实性 ,去追寻和接受生活与世界的真实意义 ,而后者则要求在思想中 ,在…     

Attending to the Sabbath: An Alternative Direction in Karl Barth's Theology of Prayer

Most accounts of Karl Barth's theology of prayer focus on the active dimensions of prayer, as prioritized in the formal sections on prayer in the Church Dogmatics. This leads to the suspicion that Barth has little time for the contemplative and reflective dimensions of prayer. This article will complement the existing approaches by broadening the scope of inquiry from the formal prayer‐sections into other, less obvious areas of the Dogmatics to uncover an alternative, contemplative, direction in Barth's theology of prayer. It will suggest, therefore, that attending to his rich but often‐neglected account of the Sabbath affords the opportunity to begin the work of reassessing Barth's relation to the contemplative tradition.     

Factors Contributing to Depression during Peri Menopause: Findings of a Pakistani Sample

The present study aimed to identify the role of different factors in menopausal depression in Pakistani women. We hypothesized that physical activity, regular exercise, social support, and attitudes towards aging and menopause would predict menopausal depression in women going through perimenopause. The sample consisted of 110 women (M _age = 47.93 years) going through natural perimenopause. The Menopausal Symptoms Scale (Nadeem and Khalid 2012) and Social Support Questionnaire (Sarason et al. 1987) were administered along with a demographic questionnaire. Multiple regression analysis was conducted to analyze the data. The results showed that higher physical activity level, satisfactory relationships with husband, and availability of social support significantly predicted lower menopause-related depression. However, satisfaction with social support did not significantly predict menopausal depression. We also observed that positive attitude towards aging and menopause was significantly correlated with decreased menopausal depression. The implications for the need to promote awareness among health professionals and the general population about menopausal symptoms in Pakistani women to improve their quality of life are discussed.