'Mid-Life crisis' and its implications in counselling

The term 'mid-life crisis' is increasingly used both in everyday speech and in the professional literature as an explanation of certain disturbing psychological symptoms and uncharacteristic behaviour in middle age. This paper outlines the symptoms and the causes presumed by a wide range o f literature (mainly American) to underlie them. It then examines empirical research for evidence of the existence and nature of the phenomenon labelled 'mid-life crisis' and, finding little, proposes alternative explanations for its symptoms and for the emergence and use of the concept in recent years. It concludes with an examination of implications for guidance and counselling.     

Patterns of conversation between clergy and their parishioners and referral to other professionals

Clergy deal with mental and physical health care issues as well as spiritual concerns within their congregations. Collaboration with psychotherapists and physicians could be argued to be "best practice" by clergy, but little is known about how clergy collaborate, particularly in non-hospital settings. This study describes reported practice patterns of referral by clergy in the context of their conversations with parishioners. Clergy report that parishioners regularly express psychosocial and medical concerns to them, and clergy also initiate these conversations. Clergy refer to medical providers and psychotherapist 23% of the time, and these referrals are found to be helpful, even though the professionals rarely connect with each other. Physicians and psychotherapists report they refer to clergy 10% and 24% of the time, respectively, and often find these referrals helpful. Further research is needed to understand the barriers and bridges to collaboration between professionals in different domains of care.     

Helping and proactive extra-role behaviors: The influence of motives, goal orientation, and social context

We explore how two motivational orientations (communion and status striving) influence three extra-role organizational behaviors: proactive engagement, providing help, and seeking help. We propose and confirm intervening mechanisms, in the form of (a) goal orientations and (b) attitudes toward coworkers. Proactive behaviors are predicted by status striving, through the intervening mechanisms of both learning and performance proving goal orientations. Providing help is, in turn, motivated by communion striving, and the relationship is mediated by goal orientations (learning and performance avoiding) and by satisfaction with and commitment to coworkers. Finally, seeking help is a function of communion striving, which influences the outcome through learning goal orientation and satisfaction with and confidence in coworkers.     

Survivor of That Time, That Place: Clinical Uses of Violence Survivors' Narratives

Narratives by survivors of abuse offer compelling entries into the experiences of abuse and its effects on health. Reading such stories can enlarge the clinician's understanding of the complexities of abuse. Furthermore, attention to narrative can enhance the therapeutic options for abuse victims not only in mental health arenas, but also in other medical contexts. In this article we define the genre of survivor narratives, examine one such narrative in particular (Push by Sapphire, 1996), and explore the clinical implications of narrative in abuse victims' clinical care.     

Effects of nonlinguistic auditory variations on lexical processing in Broca's aphasics

In a series of experiments, the effect of white noise distortion and talker variation on lexical access in normal and Broca's aphasic participants was examined using an auditory lexical decision paradigm. Masking the prime stimulus in white noise resulted in reduced semantic priming for both groups, indicating that lexical access is degraded by nonlinguistic white noise distortion. However, talker variation within a prime-target pair had no effect upon the performance of either the normal or aphasic individuals. The absence of a talker variation effect suggests that voice-specific information is not encoded in the lexical representations of words. The normal performance of Broca's aphasics under conditions of both white noise and talker variation supports the view that these patients have a lexical processing impairment rather than a more generalized language deficit characterized by limited computational resources.     

Syntactic frame and verb bias in aphasia: plausibility judgments of undergoer-subject sentences

This study investigates three factors that have been argued to define "canonical form" in sentence comprehension: Syntactic structure, semantic role, and frequency of usage. We first examine the claim that sentences containing unaccusative verbs present difficulties analogous to those of passive sentences. Using a plausibility judgment task, we show that a mixed group of aphasics performed significantly better on unaccusatives than on passives. We then turn to the observation that passives are generally harder than actives for aphasics. We show that this effect is modulated by lexical bias, i.e., the likelihood that a verb appears in a given syntactic structure: Passives of passive-bias verbs were significantly easier than passives of active-bias verbs. More generally, sentences whose structure matches the lexical bias of the main verb are significantly easier than sentences in which structure and lexical bias do not match. These findings suggest that "canonical form" reflects frequency and lexical biases.     

“Social Separation” Among Women Under 40 Years of Age Diagnosed with Breast Cancer and Carrying a BRCA1 or BRCA2 Mutation

We conducted an exploratory, qualitative study investigating experiences of women who had developed breast cancer under the age of 40 and who were identified as BRCA1 or BRCA2 mutation carriers. These germline mutation carriers face an increased lifetime risk of a second primary breast cancer and an increased risk for a primary ovarian cancer. Thirteen women who fit this criteria participated in three focus groups conducted at a major cancer center in the UK during Spring 2003. We asked broad, open-ended questions that allowed for a wide range of responses about their cancer and genetic testing experiences, physical and psycho-social concerns, family and partner reactions and their need for social support. The women expressed feelings of devastation, loneliness, feeling different and isolation, ambivalence about having to support family members, worries about partner’s anxiety and depression, and anxiety about talking to family members, especially children. These feelings were stronger after the cancer diagnosis and compounded by the genetic test results that occurred at a later time. We also found that, at least temporarily, the women experienced what we call “social separation”—emotional distance from, or dissonance with groups they interact with or are part of, e.g., family and friends, frequently leading to a reduction in communication or a change in previously unstated, but accepted normal interaction. We concentrate on a few characteristics of social separation—feelings of aloneness, isolation and separation, use of silence and verbal discretion, the relationship between estrangement and kinship interaction and norm disruption, and are looking at social patterns of interpersonal relationships that may occur when risk and illness statuses are new and framing and feeling rules have not as yet been clearly developed due to a cultural lag.     

Neonatal encephalopathy in the term infant: neuroimaging and inflammatory cytokines

The interrelationship between inflammation and ischemia is complex and poorly understood in the developing nervous system. In the preterm newborn, maternal infection may predispose to white matter injury and may be associated with cytokine elevation. In the term infant, few studies exist linking elevation of cytokines with encephalopathy and poor neurodevelopmental outcome. This review discusses the interplay among inflammatory cytokines, neonatal encephalopathy, and neuroimaging parameters.