Attributional Style, Self-Esteem, and Human Immunodeficiency Virus: A Test of the Hopelessness and Self-Esteem Theories of Depression

Research on the hopelessness and self-esteem theories of depression (Abramson, Metalsky, & Alloy, 1989; Metalsky, Joiner, Hardin, & Abramson, 1993) suggests that HIV-infected persons with depressotypic attributional style (AS) and low self-esteem (SE) may be at risk for onset of a syndrome referred to as hopelessness depression (HD). In a prospective study conducted to test these theories, measures of anxiety and depression, AS, and SE were administered to 85 HIV+ and 43 HIV– men; symptoms were reassessed 6 months later. Results indicated that: (1) The interaction of AS, SE, and HIV status predicted change in HD symptoms, but not overall depression or anxiety symptoms; (2) HIV+ men with depressotypic AS and high SE had increased HD symptom levels while other men with high SE had decreased HD symptom levels; (3) HD symptoms remained stable over the 6-month interval among men with low SE; and (4) High SE predicted decreases in anxiety symptoms among HIV– men, but not among HIV+ men. Contrary to the study hypothesis, these findings suggest that among individuals with life-threatening illnesses such as HIV infection, those with depressotypic AS and high SE may be at highest risk for onset of HD.     

医学与文学的传统及创新

论述医学与文学关系的文章习惯以阿波罗开头。文学与医学直到最近才成为医学人文学里的一个新的学术分支 ,但文学与医学的关系至少可追溯到古希腊。本文中 ,我将讨论如何看待医学与文学关系的四种传统方式 :其一 ,疾病的形象 (ｉｍａｇｅｓ) ,即文学中患病、苦难和死亡的主题 ;其二 ,治疗者的形象 ;其三 ,医生—诗人或医生—作家类型 ;其四 ,文学作为一种治疗方法。然后 ,我将简要讨论文学在今日医学教育中的作用并提供一个思辨性的结论。1　传统1 1　患病、苦难和死亡的主题与医学一样 ,文学关涉患病、苦难和死亡这些与人类同样古老的主题…     

Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation

The authors divided 34 participants who had a history of depression into 2 groups, those having previous suicidal ideation or behavior (n=19) and those having no such symptoms (n=15), then compared the 2 groups with a group of participants who had no history of depression (n=22). Assessment of interpersonal problem-solving performance using the Means-Ends Problem-Solving (MEPS) task before and after a mood-induction procedure showed that only those formerly depressed people with a history of suicidal ideation shifted in MEPS performance, producing significantly less effective problem solutions following mood challenge, consistent with a differential activation account of vulnerability for recurrence of suicidal ideation and behavior. The deterioration in effectiveness following mood challenge was moderated by lack of specificity in autobiographical memory.     

Toward a biopsychosocial model for 21st-century genetics

Advances in genomic research are increasingly identifying genetic components in major health and mental health disorders. This article presents a Family System Genetic Illness model to address the psychosocial challenges of genomic conditions for patients and their families, and to help organize this complex biopsychosocial landscape for clinical practice and research. This model clusters genomic disorders based on key characteristics that define types of disorders with similar patterns of psychosocial demands over time. Key disease variables include the likelihood of developing a disorder based on specific genetic mutations, overall clinical severity, timing of clinical onset in the life cycle, and whether effective treatment interventions exist to alter disease onset and/or progression. For disorders in which carrier, predictive, or presymptomatic testing is available, core nonsymptomatic time phases with salient developmental challenges are described pre- and post-testing, including a long-term adaptation phase. The FSGI model builds on Rolland's Family System Illness model, which identifies psychosocial types and phases of chronic disorders after clinical onset. The FSGI model is designed to be flexible and responsive to future discoveries in genomic research. Its utility is discussed for research, preventive screening, family assessment, treatment planning, and service delivery in a wide range of healthcare settings.     

Establishing derived requesting skills in adults with severe developmental disabilities

This project examined whether a history of reinforced relational responding would result in derived requesting skills in 3 adults with disabilities. Participants were first taught to request preferred items using pictures; they were then taught conditional discriminations between pictures and their dictated names and between dictated names and their corresponding text. Finally, requests for preferred items using corresponding text were evaluated. All 3 participants demonstrated derived requesting skills.     

Online attentional-focus manipulations in a soccer-dribbling task: implications for the proceduralization of motor skills

A focus of attention on the step-by-step control of a skill has been shown to be detrimental to experts' performance but to have no significant effect on novices' performance (e.g., S. L. Beilock, T. H. Carr, C. MacMahon, & J. L. Starkes, 2002), contrary to the results of manipulations of the direction of attentional focus (e.g., G. Wulf, M. H?ss, & W. Prinz, 1998). In previous studies, researchers have not separated the focus of attention from the nature of the instruction provided or the skill level of the participants. In the present experiment, 10 skilled and 10 less skilled soccer players dribbled a ball after receiving instructions directing attention to an internal, skill-relevant feature (foot); an internal, skill-irrelevant feature (arm); or a skill-irrelevant task (word-monitoring). Performance was evaluated in relation to a no-attentional-focus control condition. For skilled performers, an internal focus on the arms and feet interfered with performance. For less skilled performers, an internal, yet skill-relevant, focus of attention (foot) did not degrade performance, whereas attention to the arms and word monitoring had a detrimental effect. No significant differences were observed across the three attentional manipulations when the skilled performers used the nondominant foot. The results generally supported the deautomization of skills hypothesis.     

A case study of mediated learning, delayed auditory feedback, and motor repatterning to reduce stuttering

A case study of DW, an 11-yr. old monolingual, English-speaking boy who exhibits stuttering, language delay, and ADHD is presented. DW experienced only limited improvement during stuttering therapy received in public schools, according to parents and the public school clinician. The purpose of this case study was to assess whether fluency treatment which incorporated Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning would enhance progress. Therapy was delivered in two treatments, with each treatment being 5 wk. of intense therapy, separated by one year. Treatment 1 of combined Mediated Learning and Delayed Auditory Feedback yielded improvement in fluency, judged by parents and the teacher to be clinically significant. The improved fluency was maintained for one year when DW was pretested for participation in Treatment 2, which combined Mediated Learning, Delayed Auditory Feedback, and Speech Motor Repatterning Exercises. As no conclusions are possible, further study is needed.     

Intervention Groups for Adolescents With Conduct Problems: Is Aggregation Harmful or Helpful?

Past research has suggested that the aggregation of deviant peers during treatment may cause harmful effects (T. J. Dishion, J. McCord, & F. Poulin, 1999). This study compared the effectiveness of problem-solving skills training groups in which all members had conduct problems (pure group condition) with groups that consisted of adolescents with and without behavior problems (mixed group condition). Participants were 139 sixth- and seventh-graders (mean age = 12.7; 63% male; 55% White) enrolled at public middle schools. Pre-, post-, and 6-month follow-up data were collected, along with intervention process variables. Results showed that, contrary to the deviancy training hypothesis, adolescents in the pure-group condition engaged in more adaptive in-session behavior and received lower scores on the parent and teacher ratings of externalizing behavior at postintervention than those in the mixed-group condition. Mediation analyses showed that the deviancy training that occurred in the mixed-group condition accounted for their worse postintervention scores, findings consistent with the deviancy training hypothesis.     

Sequential processing in hemispheric word recognition: the impact of initial letter discriminability on the OUP naming effect

The cerebral hemispheres have been proposed to engage different word recognition strategies: the left hemisphere implementing a parallel, and the right hemisphere, a sequential, analysis. To investigate this notion, we asked participants to name words with an early or late orthographic uniqueness point (OUP), presented horizontally to their left (LVF), right (RVF), or both fields of vision (BVF). Consistent with past foveal research, Experiment 1 produced a robust facilitatory effect of early OUP for RVF/BVF presentations, indicating the presence of sequential processes in lexical retrieval. The effect was absent for LVF trials, which we argue results from the disadvantaged position of initial letters of words presented in the LVF. To test this proposition, Experiment 2 assessed the discriminability of various letter positions in the visual fields using a bar-probe task. The obtained error functions highlighted the poor discriminability of initial letters in the LVF and latter letters in the RVF. To confirm that this asymmetry in initial letter acuity was responsible for the absent OUP effect for LVF presentations, Experiment 3 replicated Experiment 1 using vertical stimulus presentations. Results indicated a marked facilitatory effect of early OUP across visual fields, supporting our contention that the lack of OUP effect for LVF presentations in Experiment 1 resulted from poor discriminability of the initial letters. These findings confirm the presence of sequential processes in both left and right hemisphere word recognition, casting doubt on parallel models of word processing.