Succeeding in Rural Mental Health Practice: Being Sensitive to Culture by Fitting in and Collaborating

Sustainable solutions to the access to mental health care problems are complex and must address both the availability of mental health care resources and the acceptability of those resources to consumers. The purpose of this study was to determine how to address the acceptability problem by learning from medical and mental health care providers what mental health therapists need to know to be successful in providing care in rural communities. Using a qualitative design, focus groups were conducted in three rural communities (<2,500) with medical and mental health care providers practicing in these communities. Data were analyzed using inductive qualitative methods. Results indicate that in addition to sound clinical skill, mental health therapists should (A) be sensitive to the culture of the rural community in which they are working and (B) practice in a way that accommodates to the care culture of the community. The latter includes spending time with patients commensurate with what is expected by other providers, engaging in generalist practice, and collaborating with local providers in patient care. An important implication of these results is that mental health care must be acceptable to both the residents of the community and the gatekeepers to health care.     

Longitudinal associations between low morning cortisol in infancy and anger dysregulation in early childhood in a CPS‐referred sample

Children who experience early adversity are at increased risk for developing psychopathology, and dysfunction of the hypothalamic pituitary adrenal (HPA) axis is a possible mechanism conferring this risk. This study sought to characterize the association between morning cortisol during different developmental periods and deficits in children's emotion regulation, a core feature of many psychological disorders. Morning cortisol was collected at two time points (i.e., during infancy, M = 13.0 months old, and during early childhood, M = 36.8 months old) from 120 children with histories of child protective services (CPS) involvement. Children completed a lab visit during early childhood (M = 38.6 months old) that involved an observational measure of anger regulation. Results showed that low morning cortisol during infancy, but not early childhood, predicted increased anger dysregulation during early childhood. These results highlight the importance of developmental timing in assessing the effects of HPA axis functioning and suggest that low cortisol during infancy is a risk factor for later emotion regulation difficulties.     

The Role of Reflective Functioning in Predicting Marital and Coparenting Quality

Reflective functioning (RF) is a measure of mentalization—the capacity to think about one’s own and others’ thoughts and feelings and to understand the connections between mental states and behaviors. Previous research indicates a decline in marital quality across the transition to parenthood, and some studies have found that parents are less happy than non-parents. Thus, researchers have called for research into possible moderators of these patterns. RF may help couples navigate this transition by more easily taking each other’s (and the infant’s) perspective and understanding each other’s behaviors. Much of the research on RF has focused on mothering behavior; research has not yet examined associations between RF and other family interactions. We examined associations between RF and marital and coparenting quality for both wives and husbands. Reflective functioning was coded from Adult Attachment Interviews conducted during pregnancy. We assessed marital quality at 3.5 months, and coparenting quality at 13 months, after the birth of the target child. Wives’ higher RF was associated with higher levels of positive—and lower levels of negative—marital and coparenting interactions. Wives who were better able to reflect on their early experiences with their parents were involved in marital interactions that were more positive and supportive and less conflicted and undermining. Husbands’ RF did not predict marital or coparenting quality. These findings highlight the importance of reflective functioning in understanding family functioning.     

Helping others or helping oneself? An episodic examination of the behavioral consequences of helping at work

Scholars have paid an increasing amount of attention to organizational citizenship behaviors (OCBs), with a particular emphasis on helping others at work. In addition, recent empirical work has focused on how OCB is an intraindividual phenomenon, such that employees vary daily in the extent to which they help others. However, one limitation of this research has been an overemphasis on well‐being consequences associated with daily helping (e.g., changes in affect and mental depletion) and far less attention on behavioral outcomes. In this study, we develop a self‐regulatory framework that articulates how helping others at work is a depleting experience that can lead to a reduction in subsequent acts of helping others, and an increase in behaviors aimed at helping oneself (i.e., engaging in political acts). We further theorize how two individual differences—prevention focus and political skill—serve as cross‐level moderators of these relations. In an experience sampling study of 91 full‐time employees across 10 consecutive workdays, our results illustrate that helping is a depleting act that makes individuals more likely to engage in self‐serving acts and less likely to help others. Moreover, the relation of helping acts with depletion is strengthened for employees who have higher levels of prevention focus.     

The Youth Public Arts Program: Interpersonal and Intrapersonal Outcomes for At-Risk Youth

This article provides the findings of a program evaluation of the Youth Public Arts Program, a long-standing community-based art program that serves at-risk youth in eastern North Carolina. The program evaluation was undertaken to examine the art skills, social and interpersonal skills, and community involvement of the participants. The study included four focus groups and telephone surveys with a total of 38 stakeholders (program participants, parents of participants, program staff, and referral sources). Results indicated that the at-risk youth had gains in both interpersonal and intrapersonal skills, including family relationships, peer relationships, community interaction, increased art skills, confidence, and self-regulation. This article adds to the very limited literature on community-based art programs for youth.     

Collaboration in associative recognition memory: using recalled information to defend "new" judgments

S. E. Clark, A. Hori, A. Putnam, and T. J. Martin (2000) showed that collaboration on a recognition memory task produced facilitation in recognition of targets but had inconsistent and sometimes negative effects regarding distractors. They accounted for these results within the framework of a dual-process, recall-plus-familiarity model but showed only weak evidence to support it. The present results of 3 experiments present stronger evidence for Clark et al.'s dual-process view and also show why such evidence is difficult to obtain.     

Interpretive biases in chronic insomnia: an investigation using a priming paradigm

Disorder-congruent interpretations of ambiguous stimuli characterize several psychological disorders and have been implicated in their maintenance. Models of insomnia have highlighted the importance of cognitive processes, but the possibility that biased interpretations are important has been minimally investigated. Hence, a priming methodology was employed to investigate the presence of an interpretive bias in insomnia. A sample of 78 participants, differing in the presence of a diagnosis of insomnia, severity of sleep disturbance, and sleepiness, was required to read ambiguous sentences and make a lexical decision about target words that followed. Sleepiness at the time of the experiment was associated with the likelihood with which participants made insomnia and threat consistent interpretations of ambiguous sentences. The results suggest that there is a general bias towards threatening interpretations when individuals are sleepy and suggests that cognitive accounts of insomnia require revision to include a role for interpretative bias when people are sleepy. Future research is required to investigate whether this interpretive bias plays a causal role in the maintenance of insomnia.     

Mortality Differentials and Religion in the U.S.: Religious Affiliation and Attendance

Using data from the Health and Retirement Study, I examine the relationship between adult mortality and religious affiliation. I test whether mortality differences associated with religious affiliation can be attributed to differences in socioeconomic status (years of education and household wealth), attendance at religious services, or health behaviors, particularly cigarette and alcohol consumption. A baseline report of attendance at religious services is used to avoid confounding effects of deteriorating health. Socioeconomic status explains some but not all of the mortality difference. While Catholics, Evangelical Protestants, and Black Protestants benefit from favorable attendance patterns, attendance (or lack of) at services explains much of the higher mortality of those with no religious preference. Health behaviors do not mediate the relationship between mortality and religion, except among Evangelical Protestants. Not only does religion matter, but studies examining the effect of "religiosity" need to consider differences by religious affiliation.