What role does substance use play in the social world of Australian people who have experienced homelessness? A critical realist mixed‐methods exploration

Substance use is prevalent amongst Australians who have experienced homelessness, but the social impacts of using substances amongst this group are poorly understood. This study uses a relational and critical realist approach to understand the role of substance use on the social lives of people with lived experience of homelessness. A mixed‐methods design was used to explore this question and assess the experiences of people who have exited homelessness. Recruiting across services catering to marginalised populations, 110 participants completed a cross‐sectional survey. Findings showed substance use both socially connected and disconnected participants, and that attempting abstinence required participants to negotiate and alter their social networks. To participants, being a substance “user,” or “non‐user,” was a social identity that they actively negotiated to facilitate competing social, psychological and material/embodied needs. Participants chose to engage and not engage with others to craft a social identity they valued, which had the sometimes‐negative side‐effect of limiting potential relationships, leaving users feeling isolated from their non‐users and a continued imperative to keep using. The impacts of substance use on social networks were similar for currently and formerly homeless participants, suggesting transitioning into housing may not immediately prompt a reduction in substance use or influence from substance‐using peers. Interventions with substance users with lived experience of homelessness would benefit from taking a social identity approach that incorporates an understanding of the material/embodied aspects of addiction to provide a holistic model of care that best supports the relational needs of the client.     

Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing?

Although expressive writing has positive effects on health, little is known about the underlying psychological mechanisms for these effects. The present study assessed self-affirmation, cognitive processing, and discovery of meaning as potential mediators of the effects of expressive writing on physical health in early-stage breast cancer survivors. A content analysis of the essays showed that self-affirmation writing was associated with fewer physical symptoms at a 3-month follow-up assessment, with self-affirmation writing fully mediating the effects of the emotional expression and benefit-finding writing conditions on reduced physical symptoms. Cognitive processing and discovery of meaning writing were not associated with any physical health outcomes. Consistent with evidence showing that self-affirmation plays an important role in buffering stress, the present study provides the first evidence for self-affirmation as a viable mechanism underlying the health benefits of expressive writing.     

Preverbal children with autism understand the intentions of others

There is a ‘theory of mind’ theory of autism. Meltzoff has recently developed a procedure that gives a nonverbal assessment of ‘theory of mind’. A group of children with autism and a matched control group of normally developing infants were given three of Meltzoff’s tasks and three conventional, gestural imitation tasks. The children with autism showed the expected deficits on gestural imitation, but were significantly better than the normally developing infants on the Meltzoff tasks. The implications of these results for a number of theoretical issues are discussed.     

Improving recall by recoding interfering material at the time of retrieval.

Our experiments demonstrate that interference of an interpolated list of items with recall of an original list can be substantially reduced by forming Ss just before testing how to reorganize and simplify the interpolated material. In Experiments 1 and 2, Ss better recalled an initial serial list of letters when informed at testing that an interpolated list spelled a certain phrase backward. Similarly, in Experiments 3 and 4, Ss better recalled an initial list of cities when told that the interpolated cities were also names of former U.S. presidents. Control experiments rule out several simple explanations. In contrast to an editing hypothesis, the postorganizing clue helped recall even when problems of list differentiation were minimized. Current memory models appear unable to explain this benefit of a postlearning clue that enables Ss to segregate the interpolated material from the to-be-remembered material.     

Demonstrations of a generation effect in context memory

Generation often leads to increased memorability within a laboratory context (see, e.g., Slamecka & Graf, 1978). Of interest in the present study is whether the benefits of generation extend beyond item memory to context memory. To investigate this question, in three experiments, we asked subjects to remember in which of two contexts they had read or generated words. In Experiment 1, the contexts were two different rooms; in Experiment 2A, the contexts were two different computer screens; in Experiment 2B, the contexts were different perceptual characteristics of the to-be-remembered words. In all experiments, subjects were better at remembering the context of generated words than of read words.     

Illness representations in patients with multimorbid long-term conditions: qualitative study

Most research on illness representations explores how patients view single conditions, but many patients report more than one long-term condition (known as multimorbidity). It is not known how multimorbidity impacts on patient illness representations. This exploratory qualitative study examined patients' representations of multimorbid long-term conditions and sought to assess how models of illness representation might need modification in the presence of multimorbidity. We explored two major issues: (1) the impact of multimorbidity on patient representations of their individual conditions and (2) the representation of multimorbidity itself. Twenty eight adults with at least two long-term conditions (mean of 4) were interviewed. The presence of multimorbidity impacted on patient illness representations in relation to the dimensions of identity, perceived cause, coherence and consequences. Representations of multimorbidity itself concerned representations of the burden of medication and perceived priorities among conditions and synergies and antagonisms between conditions and their management. The results have implications for the measurement of multimorbidity (through scales such as the Illness Perception Questionnaire) and the use of illness representations in the design and delivery of interventions to improve health behaviour and outcomes of patients with multiple long-term conditions.     

Effects of retinal eccentricity and acuity on global-motion processing

The present study assessed direction discrimination with moving random-dot cinematograms at retinal eccentricities of 0, 8, 22, and 40?deg. In addition, Landolt-C acuity was assessed at these eccentricities to determine whether changes in motion discrimination performance covaried with acuity in the retinal periphery. The results of the experiment indicated that discrimination thresholds increased with retinal eccentricity and directional variance (noise), independent of acuity. Psychophysical modeling indicated that the results for eccentricity and noise could be explained by an increase in channel bandwidth and an increase in internal multiplicative noise.     

Implicit memory for negative and positive social information in individuals with and without social anxiety

Studies of memory bias for threat-relevant information in individuals with social anxiety have produced mixed results. These discrepancies may be because investigators have studied different memory processes or have used different memory tasks. We employed a video clarity judgement task to investigate implicit (capacity-free, automatic, unconscious) memory and a recognition task to investigate explicit (effortful, strategic, conscious) memory for threat in socially anxious individuals and nonanxious controls. Implicit memory for "old" (i.e., seen before) videos was defined as rating "old" videos as more clear than "new" (i.e., never seen before) videos. We created brief video clips that involved an actor or actress approaching the camera and commenting on some aspect of the viewer's actions, physical appearance, or belongings. Twenty-four videos were positive (e.g., "I really like your shoes"), and 24 were negative (e.g., "That is a horrible haircut"). Results revealed that the video clarity test was an effective measure of implicit memory. Furthermore, socially anxious individuals showed a larger implicit memory index for negative videos than did nonanxious and dysphoric controls. No group differences emerged for implicit memory for positive videos. Similarly, groups did not differ in recognition of, or false alarms for, positive and negative videos. These results demonstrate the role of implicit memory in social anxiety implying that information about threat may be automatically primed in these individuals.     

A survey of genetic counselors' strategies for addressing ethical and professional challenges in practice

There is limited research about ethical and professional dilemmas that genetic counselors encounter in their practice and their strategies for addressing them. In this study, 454 genetic counselors rated the frequency with which they encounter each of 16 ethical/professional challenges identified and categorized previously (McCarthy Veach P, Bartels DM, LeRoy BS (2001) J Genet Couns 10(2):97–119). Over 40% indicated these issues occurred frequently: patient emotions, diversity, financial constraints, uncertainty, and colleague error. Two hundred and fifty-five respondents provided personal anecdotes describing exceptionally challenging situations and recommended strategies for addressing them. Most of their anecdotes involved informed consent, value conflicts, confidentiality, colleague error, withholding information, and resource allocation. The most frequently recommended strategies were further discussion with patient, consultation with other professionals, and referral to other health sources. Thirty-five respondents were unable to/did not offer strategies. Respondent demographics were not related to frequency of issues, type of anecdote, or recommended strategies. Practice, policy, and research implications are discussed.