Canada’s private sponsorship of refugees program: A practitioners perspective of its past and future

Over its history, the private sponsorship program has been an important vehicle for Canada and Canadians in their response to refugees. It has been a flexible tool able to respond to both small and large-scale resettlement needs. The result is that thousands of refugees have found a durable solution in Canada. This article chronicles the evolution of this program. It argues that while the program is driven by the interest of Canadians to assist particular refugees, it is still in keeping with the international objectives of increasing and diversifying resettlement. It identifies a number of the challenges that program faces. Ultimately, it urges that the program be given greater attention and study so as to ensure that it is able to continue to provide additional refugees with a durable solution.     

Building bridges between body and mind: The analysis of an adolescent with paralyzing chronic pain

This paper describes the evaluation, initial psychotherapy and subsequent psychoanalysis of an adolescent who presented with a severe psychosomatic process involving total body pain and profound fatigue. The author details the complex and multifaceted nature of the psychosomatic process as it unfolded in the treatment. The psychosomatic problem was not a single entity, but rather was comprised of diverse interwoven elements such as somatization, conversion on pre-oedipal and oedipal levels, conflicts over aggression, sexuality, identity, masochism, secondary gain, anaclitic depression, internalized self-other interactions with a depressed mother and transgenerational transmission of trauma. The author uses the case material to discuss technical approaches to problems that often arise in the analytic treatment of patients with complicated chronic pain and fatigue as the primary complaints. Such approaches include respecting the mind-body split as a primary defense, speaking the language of the body along with the language of the mind and developing the verbal sphere around the non-verbal symptoms. The author emphasizes that complicated chronic pain problems are common and can be helped by psychoanalysis as long as the unique and complex features are understood and reflected in the technical approach.     

Dissidence from within: Examining the effects of intergroup context on group members’ reactions to attitudinal opposition

The successful achievement of a group’s goals often requires a broad base of support among members. Because group and individual interests can diverge, however, dissension is likely. We argued that reactions to such dissension on an issue that is relevant to the group’s status can vary as a function of contextual goals. Whereas dissension from an ingroup member would be rejected in an intergroup context, it might be tolerated in an intragroup context. Regression analyses of women’s (N=96) responses to dissension on an attitudinal issue (abortion on demand) indicated that in an intergroup context, women derogated a dissenting woman more if they had a strong gender identity and viewed the issue as gender relevant. Dissent in an intragroup context was evaluated more positively. The results provided insight into the factors involved in defining a collective identity.     

Primary Care Provider Familiarity with Binge Eating Disorder and Implications for Obesity Management: A Preliminary Survey

Current guidelines for the evaluation and treatment of obesity recommend referring individuals with binge eating disorder (BED) to a mental health professional. However, it is unclear how familiar primary care providers are with BED. The purpose of this study was to assess providers' familiarity with BED diagnosis and treatment. Providers in two primary care clinics completed a questionnaire, which assessed perceived familiarity with BED and demonstrated familiarity with BED diagnosis and treatment. Results indicated that 61% of respondents demonstrated familiarity with the essential symptoms of BED, and 80% reported familiarity with the diagnosis of BED. However, 35% of respondents who perceived themselves as familiar with BED did not demonstrate familiarity with the most basic symptoms. These results demonstrate that while many providers in primary care are familiar with BED, steps to improve provider familiarity with the disorder and provide appropriate mechanisms to address BED are warranted.     

The BAI–PC as a Screen for Anxiety, Depression, and PTSD in Primary Care

Despite the prevalence of psychiatric disorders in medical settings, mental health problems often go undetected and patients do not receive appropriate treatment. The main goal of this study is to provide additional information about the Beck Anxiety Inventory – Primary Care (BAI–PC), a brief instrument that screens for patients with anxiety. This study provides information on the performance of the BAI–PC as a screening instrument for depression and PTSD in addition to its original purpose as a screening instrument for anxiety. This efficient tool can identify patients who can benefit from effective psychological treatments and facilitate referrals to psychologists working in medical settings.     

Telling a story or telling it straight: the effects of entertaining versus accurate retellings on memory

People retell events for different reasons. Sometimes they try to be accurate, other times entertaining. What characterizes retellings from different perspectives? How does retelling perspective affect later recall of events? In the current research, participants retold a story either three times or not at all. By instruction, retellings were either entertaining or accurate. Compared to accurate retellings, entertaining retellings contained more affect, but fewer sensory references. On a subsequent memory test, participants who retold with an accuracy goal recalled the greatest number of story events, and their recall protocols were the most accurate and detailed, and least exaggerated. However, recognition memory did not differ across groups, suggesting that differences in retrieval structures (necessary for recall but not recognition) were key to understanding later differences in memory. Compared to telling it straight, the creative process of telling a story leads to qualitative and quantitative changes in later recall. Copyright © 2004 John Wiley & Sons, Ltd.     

Coping with a threatened group identity: Psychosocial and neuroendocrine responses

Given the stress associated with belonging to a socially devalued group, members' reactions to a threat were evaluated within a stress and coping framework. Participants (N=72) were presented with an explicit or nonexplicit (positive vs. neutral cues) threat to a devalued identity. Regressions indicated that problem-focused coping was related to appraising the identity threat as controllable, and with a greater sense of optimism. Together these variables were associated with lower salivary cortisol levels. The role of emotion-focused coping was most evident under explicit threat conditions, such that it was associated with sustained cortisol elevations and a diminution of identity importance. The findings suggest that intergroup responses involve a complex interplay among stressor appraisals and coping propensities.     

Mothers' Reactions to Children Misbehaving in Ways That Can Lead to Injury: Implications for Gender Differences in Children's Risk Taking and Injuries

A scenario methodology in which mothers imagined themselves and their school-age children in different home situations was used to examine mothers' reactions to sons and daughters when the children were misbehaving in ways that could, and sometimes did, result in injuries. Prior to injury, mothers predominantly expressed anger to sons and disappointment to daughters, focusing primarily on safety issues in response to daughters' misbehavior and discipline issues in response to sons' misbehavior. Once an injury resulted, mothers became concerned about their children, but the degree of concern was greater for injuries to daughters than to sons. Sons' risky misbehavior was attributed predominantly to nonmodifiable characteristics, whereas daughters' risky misbehavior was attributed to factors that a parent could expect to influence. Consistent with these attributions, mothers advocated active injury-prevention approaches to prevent injury recurrence to daughters, but did not believe that much else could be done to prevent injury recurrence to sons. Generally, the pattern of results support the notion that mothers expect more risky behavior of sons than of daughters, are more concerned about injuries to daughters than sons, and believe they can have greater influence on the risk-taking behavior of daughters than sons. Implications of these results for understanding gender differences in children's risk-taking and injuries are discussed.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.