Vicarious and operant experiences in the etiology of illness behavior: A replication with healthy individuals

The purpose of the present investigation was to replicate a previous study of diabetic patients on the role of parental modeling in the etiology of illness behavior. A random sample of healthy individuals were assigned to an avoidant model (AM) (i.e. parent reported to have avoided work. chores etc. when ill) or non-avoidant model (NAM) group. Subjects subsequently provided retrospective and current information concerning their illness-behavior experiences. The results indicated that individuals with an AM reported more responsibility avoidance when ill currently and as a child compared to the NAM subjects. Additionally. AM subjects reported receiving more positive reinforcement for current illness compared to NAM subjects. It was concluded that the process by which individuals learn to respond to illness may be similar in healthy and chronically-ill individuals but that positive reinforcement for illness may be more likely to be received by healthy individuals during acute illness than by chronically-ill individuals. The present study provides further preliminary support for the learningtheory model of illness behavior.     

The Cinema of Control: On Diabetic Excess and Illness in Film

While not rare, films that represent diabetes must work around the disease’s banal invisibility, and images of diabetics in film are especially susceptible to metaphor and exaggeration. This essay is the first to outline a diabetic filmography, discussing medical and cinematic strategies for visualizing the disease as well as how the illness informs family plots and heroic characters in horror films. Doing so, it participates in a larger discussion of the manner in which film images of ill or disabled groups sustain notions of “normalcy” by both representing and denying otherness.     

The Effects of Time Pressure on Controlling Reactions to Persons With Mental Illness

Population surveys suggest that the general public stigmatizes persons with mental illness less than in the past. However, implicit attitude measures find that immediate reactions to mentally ill persons are still negative among both the general public and people diagnosed with mental illness. Time-course data suggest that these reactions may be dynamic, with immediate negative reactions becoming less prejudicial over time. We manipulated time pressures imposed upon social judgments about a mentally ill person. Participants perceived a mentally ill person as dangerous when forced to respond quickly; participants given ample time to respond were less likely to have this perception.     

Geographical Concomitants of Negro Criminal Intelligence

This study attempts to demonstrate the relationship between teachers’ personal early experiences of attachment with their parents and their emotional, cognitive, and behavioral reactions to a hypothetical student's request to speak with them, expressed in short or detailed form. A similar procedure has been used by Perrine and Steele King for students, and now has been used for teachers. For this purpose, self-report questionnaires were administered to a sample of 395 female teachers. The results showed a significant relationship between parental bonding experiences and behavioral and emotional, but not cognitive, reactions to an hypothetical student's request. The optimal parenting group reported more positive emotional and behavioral reactions, while the affectionate control group reported more negative emotional reactions to the hypothetical student's request than the other groups. These results offer useful implications to be utilized in teachers’ training programs.     

Differential Outcomes of Adolescents with Chronically Ill and Healthy Parents

Approximately 10% of children grow up with a parent who has been diagnosed with a chronic medical condition (CMC) and seem to be at risk for adjustment difficulties. We examined differences in behavioral, psychosocial and academic outcomes between 161 adolescents from 101 families with a chronically ill parent and 112 adolescents from 68 families with healthy parents, accounting for statistical dependence within siblings. Children between 10 and 20 years and their parents were visited at home and filled in questionnaires. Multilevel analyses showed that 20–60% of the variance in most adolescent outcomes was due to the family cluster effect, especially in internalizing problem behavior, caregiving variables and quality of parent attachment. Conversely, the variance in stress and coping variables and grade point average (GPA) was mainly due to individual characteristics. Adolescents with parents affected by CMC displayed more internalizing problems than the comparison group and scored higher on frequency of household chores, caregiving responsibilities, activity restrictions, isolation, daily hassles and stress. In addition, their grade point average was comparatively worse. No group differences in externalizing problems, coping skills and quality of parent attachment were found. In conclusion, the family cluster effect largely explains adolescent outcomes and should be accounted for. Adolescents with parents affected by CMC are subject to an increased risk for internalizing problems, adverse caregiving characteristics, daily hassles, stress and a low GPA. According to a family-centered approach, school counselors and health care practitioners should be alert to adjustment difficulties of children with a chronically ill parent.     

抢救一例Rh阴性稀有血型危重孕妇的体会与思考

Rh阴性稀有血型危重患者的临床救治相当棘手。本文通过回顾对一名Rh阴性血型危重孕妇的临床救治经过,探讨了应急情况下Rh阴性血型危重患者的临床救治策略和采供血应急措施,建议我国尽快建立稀有血型血库和制定相关法律法规,为应急情况下抢救Rh阴性血型患者提供依据和保障。     

Family and childhood adjustment in cystic fibrosis

Family adaptation has been commonly associated with the psychological adjustment of chronically ill children. However, few studies have attempted to systematically evaluate this association and its relationship to illness severity. We studied 44 children ages 7 to 15 and their families at a large cystic fibrosis center and obtained measures of 1) impact of illness on the family; 2) family functioning; 3) behavioral adjustment; 4) social competence; 5) ratings of anxiety, depressive, and eating disorder symptoms; and 6) ratings of illness severity and duration. Impact of illness on the family and overall family dysfunction were significantly correlated with illness severity, but not duration. However, impact of illness on the family was significantly correlated with internalizing behavioral symptoms, while family dysfunction was correlated with depressive symptomatology. These findings suggest that illness-related stress is primarily reflected in general emotional and behavioral symptoms, with familial adaptation either ameliorating or exacerbating their development into depressive symptomatology.     

Character and behavior in the mentally ill and well mother

The purpose of this study was to examine character and behavior in a group of mentally ill and well mothers. Mentally ill mothers differed from well mothers in mother-child interaction in their positive involvement in the feeding context and in overall optimal mothering during feeding. On measures of intrapsychic conflict and concern, mentally ill mothers demonstrated significantly more conflict in areas of trust, anger, self-esteem, mutuality and nurturance and more concern with issues of self-esteem, and giving and caring than well mothers. For the mentally ill mothers postpartum onset of illness and number of separations from her child were related to some aspects of character and behavior.     

Race-Related Differences in the Experiences of Family Members of Persons with Mental Illness Participating in the NAMI Family to Family Education Program

Families play an important role in the lives of individuals with mental illness. Coping with the strain of shifting roles and multiple challenges of caregiving can have a huge impact. Limited information exists regarding race-related differences in families’ caregiving experiences, their abilities to cope with the mental illness of a loved one, or their interactions with mental health service systems. This study examined race-related differences in the experiences of adults seeking to participate in the National Alliance on Mental Illness Family-to-Family Education Program due to mental illness of a loved one. Participants were 293 White and 107 African American family members who completed measures of problem- and emotion-focused coping, knowledge about mental illness, subjective illness burden, psychological distress, and family functioning. Multiple regression analyses were used to determine race-related differences. African American caregivers reported higher levels of negative caregiving experiences, less knowledge of mental illness, and higher levels of both problem-solving coping and emotion-focused coping, than White caregivers. Mental health programs serving African American families should consider targeting specific strategies to address caregiving challenges, support their use of existing coping mechanisms and support networks, and increase their knowledge of mental illness.     

The relationship of appraisal and coping to chronic illness adjustment

There is evidence that adaptation to chronic illness may be affected by psychological factors, especially how patients appraise and cope with the stress of their illness. The purpose of the present study was to examine the relationship of stress appraisal and coping responses to multiple behavioral indices of illness adjustment among patients with diverse chronic medical conditions. One hundred and one patients admitted to a multidisciplinary medicine/psychiatry unit completed measures of functional impairment, depression, symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical regression analyses indicated that emotion-focused coping was positively related to poor psychosocial adjustment and depression after controlling for physician rated disease severity. Appraising chronic illness as holding one back predicted greater emotion-focused coping responses and poorer adjustment to illness. The use of problem-focused coping strategies was generally unrelated to illness adjustment. These findings suggest the presence of an emotion-focused coping triad consisting of wishful thinking, self blame, and avoidance, all of which appear to be maladaptive strategies when coping with chronic medical conditions. Implications for coping skills training and the need for longitudinal research is discussed.     

Demon or disorder: A survey of attitudes toward mental illness in the Christian church

The present study assessed the attitudes and beliefs that mentally ill Christians encountered when they seek counsel from the church. Participants (n?=?293) completed an anonymous online survey in relation to their interactions with the church. Analysis of the results found that while a majority of the mentally ill participants were accepted by the church, approximately 30% reported a negative interaction. Negative interactions included abandonment by the church, equating mental illness with the work of demons, and suggesting that the mental disorder was the result of personal sin. Analysis of the data by gender found that women were significantly more likely than men to have their mental illness dismissed by the church and/or be told not to take psychiatric medication. Given that a religious support system can play a vital role in recovery from serious mental disorders, these results suggest that continued education is needed to bring the Christian and mental health communities together.     

An index of relationship quality based on attachment theory

Two measures are reported of the nature or quality of a mother-offspring (MO) relationship during development using brown capuchin monkeys (Cebus apella) as models. One is a qualitative classification of MO relationships as secure, resistant, or avoidant attachments. The other is an empirical ratio of relative affiliation to agonism called the MO relationship quality, or MORQ, Index. The two methods tapped similar relationship features so relationships high or low of a median split of MORQ values were heuristically labeled secure (n = 22) or insecure (n = 16), respectively. A comparison revealed extensive behavioral differences between secure and insecure MO relationships and suggested MORQ provided an objective, continuous measure of attachment security.     

Shame in Physician–Patient Interactions: Patient Perspectives

This study estimated the extent to which shame is elicited in physician–patient interactions and examined the emotional and behavioral reactions of patients to such interactions. A large adult sample (N = 915) reported on their shame-provoking experiences in interactions with physicians through an anonymous survey. Half of all respondents (n = 456) recalled one or more interactions with a physician that left them feeling ashamed, with significantly more women (59%) than men (39%) reporting this. Forty-five percent of those reporting such experiences stated they terminated treatment with, avoided, or lied to their physician to avoid experiencing further shame. However, 33% believed the shame-provoking interaction provoked useful behavioral changes, and 46% were, on balance, grateful to the physician. Women, relative to men, reported that the interaction led to more negative emotional and behavioral consequences. The type of health issue involved in the interaction also was associated with differential outcomes. Thus, it appears that inducing shame in medical contexts is widespread and may well have both positive and negative effects.     

“It Depends on What You Mean by ‘Disagree’”: Differences between Parent and Child Perceptions of Parent–Child Conflict

We examined a new structured interview of parent?Cchild conflict that assesses parent and child perceptions of behavioral conflict about daily life topics (e.g., doing chores, homework), and whether discrepancies exist on beliefs about these topics. In a sample of 100 parents and children ages 10 to 17?years (M?=?13.5?years, 52 males, 57?% African-American), informants could reliably distinguish between perceived behavioral conflicts and perceived discrepant beliefs about topics. These scores were also significantly related to questionnaire reports of parent?Cchild conflict. Parent and child questionnaire reports did not significantly differ, yet on the structured interview, parents reported significantly greater levels of perceived conflict and discrepant beliefs relative to child reports. Additionally, structured interview reports of conflict demonstrated incremental validity by relating to child self-reports of delinquent behaviors, when accounting for questionnaire conflict reports. The findings have implications for increasing understanding of the links between parent?Cchild conflict and psychosocial outcomes.     

Parent Stress and Coping: Waiting for a Child to Receive a Kidney Transplant

The current study examined the degree of parent stress and depression among mothers and fathers of children with end-stage renal disease (ESRD) listed for a kidney transplant, to determine whether demographic factors, stress, and coping would predict parent depression. Eighty-six mothers and 58 fathers of children with ESRD preparing for a kidney transplant completed standardized measures of parent stress related to the child’s chronic illness (PIP), coping style (Brief Cope), and depression (BDI-II). Information about the disease was obtained from the medical record. Maternal depression was predicted by having a lower family income, higher degree of parent stress associated with the child’s illness, and the use of avoidant coping strategies. Paternal depression was only predicted by higher parent stress. Illness related variables did not contribute significantly to the understanding of parent outcomes. Pre-transplant evaluations should screen for elevated levels of stress and depression, and develop interventions to help parents cope with their child’s renal disease.     

The effects of parental illness and other ill family members on youth caregiving experiences

Informed by a model of family role redistribution derived from the family ecology framework, this study examined differences in two proposed psychological components of role redistribution (youth caregiving experiences and responsibilities) between youth of a parent with illness and their peers from ‘healthy’ families controlling for the effects of whether a parent is ill or some other family member, illness type and demographics. Based on self-report questionnaire data, four groups of Australian children were derived from a community sample of 2474 youth (‘healthy’ family, n = 1768; parental illness, n = 336; other family member illness (OFMI), n = 254; both parental and OFMI, n = 116). The presence of any family member with a serious illness is associated with an intensification of youth caregiving experiences relative to peers from healthy families. This risk is elevated if the ill family member is a parent, if more illnesses are present and by certain youth and family demographics, and especially by higher caregiving responsibilities. The presence of a family member, particularly a parent, with a serious medical condition has pervasive increased effects on youth caregiving compared to healthy families, and these effects are not fully accounted for by illness type, demographics or caregiving responsibilities.     

Stressors and Stress Reactions Among University Personnel

A large, ethnically diverse, and representative sample of university workers in administrative, instructional, and blue-collar/clerical support categories were administered a battery of questionnaires designed to assess job and nonwork stress, biopsychosocial reactions to stress, emotionality, medical symptoms and utilization, and perceived social support, among other variables. A total of 831 participants returned questionnaires. The principal results showed that job and nonwork stress correlated positively with behavioral, cognitive, and physiological reactions to stress as well as with negative emotionality. Job and nonwork stress correlated meaningfully with medical symptoms; nonwork stress also correlated at a useful level with reported medical utilization. Social support did not generally modulate reports of stress or reactions to stress. It was also found that support staff reported higher levels of nonwork stress and lower levels of work stress, but that 2 measures of job stress did not differentiate administrative and instructional personnel. Younger staff reported higher levels of job and nonwork stress, and females reported higher levels of nonwork stress, irrespective of job category. The results were discussed in terms of their importance for understanding the nature of stress among personnel on the university campus and in relation to prior research.     

Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear

This study examined the specificity of disgust sensitivity in predicting contamination-related anxiety and behavioral avoidance. Participants high (n=26) and low (n=30) in contamination fear completed self-report measures of disgust sensitivity, contamination cognitions (overestimation of the likelihood and severity of contamination from everyday objects), anxiety, and depression. They then completed three randomly presented contamination-based behavioral avoidance tasks (BATs) that consisted of exposure to a used comb, a cookie on the floor, and a bedpan filled with toilet water. Results indicated that disgust sensitivity was significantly associated with anxious and avoidant responding to the contamination-related BATs. This association remained largely intact after controlling for gender, contamination fear group membership, anxiety, and depression. Contamination cognitions were also significantly related to BAT responses. However, this relationship was fully mediated by disgust sensitivity. These findings indicate that disgust sensitivity has a specific and robust association with contamination concerns commonly observed in obsessive compulsive disorder. The findings are discussed in the context of a disease-avoidance model.     

More than just child’s play: symbolic expressions of illness and spirit

While spiritual well-being is integral to health, little is known about the spiritual lives of children in the context of illness. Because the spiritual is often a hidden domain of life, exploration of the topic can be challenging, especially when dealing with children. Language is not always sufficient for describing such deeply held experiences, even for adults. Therefore, finding creative ways to elicit experiences of the spiritual is important when attempting to gain a more robust understanding of this phenomenon. Drawing from a larger study that used hermeneutic phenomenology to explore spirituality among ill children, this paper provides an interpretation of ill children’s play experiences and describes how these experiences provide a means of uncovering the spiritual in children’s everyday lives as they cope with life-threatening illness. Findings also provide insight into how play can be used in the promotion of spiritual well-being.     

Finding benefit in breast cancer: Relations with personality,coping, and concurrent well-being

Cancer patients experience positive as well as adverse consequences from cancer diagnosis and treatment. The work reported here was part of an effort to characterize the experiences of benefit finding in breast cancer patients. A sample of 230 early-stage breast cancer patients completed a set of benefit finding items in the year post-surgery. This measure was then related to measures of concurrent coping, several aspects of psychosocial well-being, demographic variables, and several other personality traits. Benefit finding related positively to trait optimism, and to positive reframing and religious activity as coping reactions. Benefit finding related inversely to emotional distress, but was relatively unrelated to other measures of well-being.