The 2004 Indian Ocean Tsunami Catastrophe,its Survivors,Job and the Universal Features of Suffering: A Theoretical Study

The purpose of this theoretical article is to discuss the existential and universal feature of suffering—as illustrated by Job’s suffering in the Book of Job in the Bible and by the survivors of the 2004 Asian tsunami catastrophe—and to highlight its significance for health care. Further, the study is aiming at contributing to health professionals’ understanding of patients’ suffering. The sources are narratives, comprising Job’s book, TV interviews 1 year after the tsunami catastrophe and the survivors’ autobiographies. The methodological approach is a philosophical analysis. The existential, universal, ontological and epistemological aspects of suffering are carefully scrutinized to unveil the universal and existential versus culture-specific features of suffering. Based on the results, the authors’ recommendations are (1) a holistic concept of the patient and health care has to seriously consider suffering in all its complexity because when a person is in pain, it is not his/her body but the whole person as a unity of body, psyche and spirit that suffers and (2) suffering should be seen as the most central concept of health care, which should provide treatment for physical pain and all dimensions of suffering: physical, social, mental and spiritual aspects.     

Cognitive functioning and cortisol profiles in first episode major depression

Major Depressive Disorder (MDD) is often associated with high levels of stress and disturbances in the Hypothalamic Pituitary Adrenal (HPA) system, yielding high levels of cortisol, in addition to cognitive dysfunction. Previous studies have shown a relationship between cortisol profile and cognitive functioning in recurrent MDD in general. More specifically, the association between hypercortisolism and cognitive functioning, such as memory and Executive Functioning (EF), and also more recently cortisol suppression has been explored. However, no studies have investigated these relationships in patients diagnosed with first episode MDD. The aim of the present study was to examine the relationship between cortisol levels before and after the Dexamethasone suppression test (DST) and cognitive function in first episode MDD patients. Twenty‐one patients meeting the DSM‐IV criteria for a first episode of MDD diagnosis were included in the study. The control group was matched for age, gender and education level. Cortisol was measured in saliva collected with Salivette sampling devices. Saliva samples were collected 4 times during a 24 hours period over two consecutive days: at awakening, after 45 minutes, after 7 hours and at 11 pm. Dexamethasone (1.0 mg) was given orally on Day 1 at 11 pm. The neuropsychological test battery consisted of standardized tests measuring executive functioning (EF) and memory functioning. Cortisol levels did not differ significantly between patients and controls on Day 1, except for the last sample before Dexamethasone administration, where the control group showed higher levels. Both groups showed suppression after Dexamethasone. On Day 2 there was a significant difference between groups at the third sample, showing a significantly lower level in the control group, suggesting that the controls have a more effective suppression profile than the patients. There were no significant correlations between cortisol levels before or after Dexamethasone and cognitive measures. The results indicate impairment on HPA‐axis functioning in first episode MDD patients, with less suppression functioning compared to healthy controls, but no relationship between cortisol profile and cognitive functioning in EF or Memory.     

Antisocial behavior reduces the association between subdimensions of ADHD symptoms and alcohol use in a large population‐based sample of adolescents

The aim of this study was to investigate possible effects of antisocial behavior on reducing the association between subdimensions of ADHD symptoms (inattention, hyperactivity and impulsivity) and alcohol use. Boys and girls were analyzed separately using a population‐based Swedish adolescent sample. A randomly selected cross‐sectional survey was performed in secondary and upper secondary schools in Västmanland County during 2010. Participants were a population of 2,439 15–16 year‐olds and 1,425 17–18 year‐olds (1,947 girls and 1,917 boys). Psychosocial adversity, antisocial behaviors, symptoms of ADHD and alcohol use were assessed by questionnaires. Except for girls' inattention, subdimensions of ADHD symptoms were not associated with alcohol use when variance due to antisocial behavior was accounted for. Among boys, instead of an indirect effect of antisocial behavior on the association between impulsivity and alcohol use, a moderating effect was found. Among girls, the inattention component of ADHD was independently associated with alcohol use even when adjusted for antisocial behavior. The reduced associations between symptoms of hyperactivity, impulsivity, and alcohol use for boys and girls after adjusting for antisocial behavior suggest a considerable overlap between hyperactivity, impulsivity, and antisocial behavior. The direct pathway between inattention and alcohol use among girls suggests that girls with inattention symptoms are at risk of alcohol use regardless of antisocial behavior. Special attention should be given to these girls. Accounting for antisocial behavior reduced the relation between subdimensions of ADHD symptoms and alcohol use, and antisocial behaviors should therefore be screened for when symptoms of ADHD are present.     

Parent–child warmth as a potential mediator of childhood exposure to intimate partner violence and positive adulthood functioning

Background and Objectives: Links between childhood exposure to intimate partner violence (IPV) and adult functioning are clear, but less research has examined the potential underpinnings of this association, especially the long-term effects of the parent–child relationship on adult well-being. We hypothesized that (i) childhood exposure to IPV would be negatively related to parent–child warmth and positively related to symptoms of psychopathology during adulthood and (ii) the relationship between IPV exposure and positive outcomes in adulthood (i.e., high life satisfaction and low psychopathology) would be mediated by parent–child warmth. Design: Participants included 703 Swedish adults (20–24). Methods: Participants responded to a self-report survey assessing violence exposure, parental warmth in childhood, and current mental health and well-being. Using multivariate regression and path analysis, models of the relationships between IPV exposure, parent–child warmth, symptoms of psychopathology during adulthood, and life satisfaction were examined. Mediation models were considered exploratory. Results: IPV exposure was related to lower levels of parent–child warmth, higher levels of psychopathology symptoms, and lower life satisfaction. The relationship between IPV exposure and positive outcomes in adulthood was mediated by parent–child warmth. Conclusions: Warm parent–child interactions may play a key role in long-term positive functioning for those exposed to IPV during childhood.     

Does Semantics Need Normativity? Comments on Allan Gibbard,Meaning and Normativity

In the book Gibbard proposes, first, that statements about meaning are normative statements and, second, that they can be given an expressivist treatment, along the lines of Gibbard’s preferred metaethics. In my paper, I examine the first step: The claim that meaning statements are to be construed as being normative, as involving ‘oughts’. Gibbard distinguishes two versions of the normativity of meaning thesis – a weak version, according to which every means implies an ought, and a strong version, according to which for every means, there is an ought that implies it. I argue that neither thesis withstands scrutiny. The weak thesis depends on assumptions about the notion of semantic correctness that the anti-normativist rejects, and the strong thesis does not solve the problems Gibbard wants it to solve: the problems of indeterminacy and meaning skepticism. I conclude that semantics does not need normativity.     

Chronic Illness and Child Behavior Problems in Low-SES Families: The Mediation of Caregivers’ Mental Health

Journal of Child and Family Studies - Childhood chronic illness is associated with deleterious effects on caregivers’ mental health and children’s socio-emotional development. This...     

A contextual approach on sex-related biases in pain judgements: The moderator effects of evidence of pathology and patients’ distress cues on nurses’ judgements of chronic low-back pain

Although women report feeling more pain than men, their pain is often underdiagnosed and undertreated. By proposing a gender-based theoretical conceptualisation, we argue that such sex-related biases may be enhanced or suppressed by contextual variables pertaining to the clinical situation, the perceiver or the patient. Consequently, we aimed to explore the moderator role of two clinically relevant variables in a chronic low-back pain (CLBP) scenario: diagnostic evidence of pathology (EP) and pain behaviours conveying distress. One-hundred and twenty-six female nurses (M?=?35.33, SD?=?7.64) participated in an experimental between-subjects design, 2 (patient's sex)?×?2 (EP: present vs. absent)?×?2 (pain behaviours: with vs. without distress). Independent variables were operationalised by vignettes depicting a patient with CLBP. Nurses judged the patient's pain on several dimensions: (1) credibility; (2) disability; (3) severity of the clinical situation; (4) psychological attributions and (5) willingness to offer support. Main findings showed that judgements of women's pain were influenced by EP, while judgements of men's pain were not. Moreover, nurses showed biases against men, but only in the presence of EP. The influence of distress cues was less consistent. Theoretical and practical implications are drawn.     

Work performance norms and organizational efficacy as cross-level effects on the relationship between individual perceptions of self-efficacy,overcommitment, and work-related stress

In the past 10 years, there has been increasing interest in applying multilevel analysis to explain how psychosocial work conditions may influence organizational behaviour. In the present study, we investigated how the individual level variables of self-efficacy and overcommitment may relate to job stress within an analytic context controlling for the main effects of dimensions of the psychosocial work environment, as well as the employees' collective perceptions of work performance norms and organizational efficacy beliefs. The final sample consisted of 924 employees from the food and beverage industry in Norway. Hierarchical linear analysis shows that overcommitment and self-efficacy together have significant main effects on stress. As expected, the results show that overcommitment is positively related to experiences of stress and self efficacy is negatively related to work-related stress. Norms governing performance, magnitude of production, attendance, and work pressure in the workplace are directly and positively related to job stress experiences at the individual level. Contrary to our expectations we did not find a significant interaction effect of work performance norms, nor did we find main or interactional cross-level effects of organizational efficacy on stress.     

Cultural variation in psychopathology: From research to practice

In the context of a Professional Doctorate in Psychoanalytic Research, we examined how a group of psychoanalytic therapists responded to the ethos and methods of qualitative research. Although experienced therapy practitioners, the students were mostly new to qualitative research. We were interested in the extent to which students found psychoanalytic training and qualitative research compatible or in conflict. The data for the study was a focus group in which students discussed the experience of becoming researchers. The focus group was recorded, transcribed and analysed using Discursive Psychology but also informed by psychoanalytic analysis, in an iterative process including the participants. We concentrate here on some of the main discourses emerging, including intrinsic and extrinsic motivations for the course – bound up with life stage, sense of previous unfulfilled aspirations and the current challenges of working in UK mental health services. We also focus on tensions with the concept of developing a researcher identity, both concerning clinician identities and other roles. The sense of an uncomfortable ‘assimilation’ into a ‘foreign territory’ was explored, both in the focus group and the analysis. We use this to highlight some of the expectations and taboos of both psychoanalytic and research communities.