Expressive disclosure and benefit finding among breast cancer patients: mechanisms for positive health effects.

A randomized trial (n = 60; A. L. Stanton, S. Danoff-Burg, L. A. Sworowski, et al., 2002) revealed that 4 sessions of written expressive disclosure or benefit finding produced lower physical symptom reports and medical appointments for cancer-related morbidities at 3-month follow-up among breast cancer patients relative to a fact-control condition. The goal of this article is to investigate mechanisms underlying these effects. Within-session heart rate habituation mediated effects of expressive disclosure on physical symptoms, and greater use of negative emotion words in essays predicted a decline in physical symptoms. Postwriting mood and use of positive emotion and cognitive mechanism words in essays were not significant mediators, although greater cognitive mechanism word use was related to greater heart rate habituation and negative emotion word use.     

Forgiveness in Javanese collective culture: The relationship between rumination,harmonious value,decisional forgiveness and emotional forgiveness

Forgiveness in Javanese collective culture is examined by considering harmonious value (HV) a subjective value on maintaining social harmony and rumination. In Study 1, we conducted an exploratory sequential mixed‐method study to develop a scale measuring HV. In‐depth interviews with eight Javanese adolescents revealed three major domains of HV (Study 1a). In a second quantitative study (Study 1b), we developed items and assessed 347 Javanese adolescents in Yogyakarta, Indonesia. Principal component analysis and confirmatory factor analysis supported three factors: cooperation during conflict, forbearing and resolving conflict. After confirming that the translated scales had acceptable reliability, we conducted Study 2 with 424 Javanese adolescents from both urban and village settings. Using hierarchical multiple regression, we found that HV accounted for a variance in decisional forgiveness above and beyond rumination. In addition, decisional forgiveness also accounted for variance in emotional forgiveness above and beyond rumination. In fact, HV accounted for variance in emotional forgiveness above and beyond both rumination and decisional forgiveness together. This revealed the importance of valuing social harmony in this collectivistic culture. Moreover, decisional forgiveness was also important in predicting the Javanese collectivists’ emotional forgiveness.     

Psychosocial Impact of a Positive Gene Result for Asymptomatic Relatives at Risk of Hypertrophic Cardiomyopathy

Families with a history of hypertrophic cardiomyopathy (HCM) may be offered genetic testing in addition to clinical surveillance. Asymptomatic family members who are gene positive (silent gene carriers) represent a new group of “patients” who may not develop HCM, with little evidence available to assist clinical management. This study explored experiences of HCM genetic testing to identify potential benefits and harms. Thirty-two individuals previously offered genetic testing for HCM were recruited. Semi-structured interviews were conducted face-to-face or by phone, and transcribed audio-recordings were coded using framework analysis. Key themes were as follows: (1) helping the next generation, (2) misunderstanding risk, (3) discrepancy between actual/perceived impact. Participants described multiple psychological (shock, worry, uncertainty) and behavioural (career, sport, insurance, family planning) consequences, depending on perceived risk. Most considered only the benefits of genetic testing for children or grandchildren, but there were some cases of significant adverse impact. The interpretation of the HCM genetic test result is variable for silent gene carriers and can lead to psychological and behavioural changes. The impact of a positive gene result may be mitigated by increased clarity of the clinical consequences and efforts to ensure informed decision-making, highlighting even further the important role of cardiac genetic counselling.     

Cultural Sensitivity as an MFT Common Factor

Cultural sensitivity is a state of attunement, emotional resonance with, and meaningful responsiveness to others. MFT professionals continue to discuss cultural sensitivity in relationship to models and therapists. We see cultural sensitivity as a common factor that spans models, rather than resides within them. We present a case vignette to illustrate the distinction between doing cultural sensitivity and being culturally sensitive. We also discuss implications of conceptualizing cultural sensitivity as an MFT common factor for teaching and research.     

Using motivational interviewing as a supplement to obesity treatment: a stepped-care approach.

OBJECTIVE: This investigation was designed to improve behavioral weight loss program (BWLP) treatment outcomes by providing stepped care (SC) to individuals experiencing difficulties with weight loss during treatment. SC entails transition to more intensive treatments when less intensive treatments fail to meet treatment goals. In a BWLP, motivational interviewing (MI) may increase participants' motivation toward behavioral change and thus complement the acquisition of behavioral change skills. It was hypothesized that BWLP+SC (MI) participants (i.e., participants who failed to meet weight loss goals and received MI) would demonstrate superior treatment outcomes when compared with BWLP (SC matched) participants (i.e., participants who failed to meet weight loss goals but did not receive MI). DESIGN: Fifty-five obese, sedentary adults were randomly assigned to a BWLP+SC or a BWLP. MAIN OUTCOME MEASURES: Changes in weight, cardiorespiratory fitness, self-reported physical activity, and diet (i.e., calories, percentage daily intake of fat, protein, and carbohydrates) in response to treatment were assessed. RESULTS: Participants significantly decreased their weight, increased physical activity/fitness, and improved dietary intake (ps<.05). BWLP+SC (MI) participants lost more weight and engaged in greater weekly exercise than BWLP (SC matched) participants who did not receive MI (ps<.05). CONCLUSION: For individuals experiencing weight loss difficulties during a BWLP, MI may have considerable promise.     

SBNR Identity: The Role of Impersonal God Representations,Individualistic Spirituality,and Dissimilarity With Religious Groups

We conducted two studies investigating the extent to which self-identification as Spiritual but not Religious (SBNR) was associated with (H1) the development of idiosyncratic religious beliefs and exposure to religious diversity and/or (H2) negative attitudes toward organized religion and being hurt by members of a religious group. In Study 1, SBNRs scored higher than religious and nonreligious participants on belief in God as an impersonal cosmic force (but not as a personal being) and individualistic spirituality. Although SBNRs had positive attitudes toward religion, they were less positive than those identifying as religious. Exposure to religious diversity and hurt by religious groups were not significant predictors of SBNR. We replicated these results in Study 2 using a multi-item measure of God representations and also found that SBNRs’ attitudes toward religion were predicted by a perceived dissimilarity with religious groups over and above individualism, secular group participation, perceptions of Christianity as too structured, and liberalism.     

A taxometric study of hypochondriasis symptoms

Hypochondriasis has been conceptualized as both a distinct category that is characterized by a disabling illness preoccupation and as a continuum of health concerns. Empirical support for one of these theoretical models will clarify inconsistent assessment approaches and study designs that have impeded theory and research. To facilitate progress, taxometric analyses were conducted to determine whether hypochondriasis is best understood as a discrete category, consistent with the DSM, or as a dimensional entity, consistent with prevailing opinion and most self-report measures. Data from a large undergraduate sample that completed 3 hypochondriasis symptom measures were factor analyzed. The 4 factor analytically derived symptom indicators were then used in these taxometric analyses. Consistent with our hypotheses and existing theory, results supported a dimensional structure for hypochondriasis. Implications for the conceptualization of hypochondriasis and directions for future study are discussed.     

Economic Disadvantage at the Intersections: Contemporary Stereotypes in the Headlines

Effective multiculturally competent treatment of economically disadvantaged clients requires an awareness of the stereotypes and biases that these clients and their families face in contemporary culture—stereotypes that are so pervasive that they can subtly influence counselors’ thinking about poor and working‐class individuals. In this article, the authors apply an intersectional perspective to profile current stereotypes and biases that exist regarding low‐income groups at the intersections of race, religion, and immigration status. Implications for educators and counselors are suggested. Un tratamiento efectivo y multiculturalmente competente de clientes e conómicamente desfavorecidos requiere una conciencia de los estereotipos y prejuicios que estos clientes y sus familias enfrentan en la cultura contemporánea; estereotipos tan arraigados que pueden influir sutilmente en la forma de pensar de los consejeros sobre las personas pobres y de clase trabajadora. En este artículo, los autores aplican una perspectiva interseccional para perfilar estereotipos y prejuicios actuales que existen acerca de grupos de bajo nivel económico en las intersecciones entre raza, religión y estatus migratorio. Se sugieren implicaciones para educadores y consejeros.     

Effects of acceptance-oriented versus evaluative emotional processing on heart rate recovery and habituation

The effects of emotional processing on stress response trajectories may depend on the nature of processing, as evaluative rumination about emotions can prolong distress. In contrast, observing negative emotions in an accepting manner may promote efficient recovery from stressful situations. The present study examined the effect of acceptance-oriented versus evaluative emotional processing on cardiovascular habituation and recovery. Across two experimental sessions, 81 participants were randomly assigned to write about an ongoing stressful experience while either (1) evaluating the appropriateness of their emotional response (EVAL), (2) attending to their emotions in an accepting way (ACC), or (3) describing the objective details of the experience (CTL). Heart rate was assessed continuously throughout baseline, writing, and recovery. Results suggest that writing about emotions in an evaluative way leads to less efficient heart rate habituation and recovery than processing emotions in an accepting manner. These findings highlight a potential mechanism of mindfulness- and acceptance-based interventions' effects on health outcomes and further suggest that habitually evaluating the appropriateness of one's emotional responses rather than accepting them as they unfold may have consequences for cardiovascular health.     

Starting over: international adoption as a natural experiment in language development

Language development is characterized by predictable shifts in the words children produce and the complexity of their utterances. Because acquisition typically occurs simultaneously with maturation and cognitive development, it is difficult to determine the causes of these shifts. We explored how acquisition proceeds in the absence of possible cognitive or maturational roadblocks, by examining the acquisition of English in internationally adopted preschoolers. Like infants, and unlike other second-language learners, these children acquire language from child-directed speech, without access to bilingual informants. Parental reports and speech samples were collected from 27 preschoolers, 3 to 18 months after they were adopted from China. These children showed the same developmental patterns in language production as monolingual infants (matched for vocabulary size). Early on, their vocabularies were dominated by nouns, their utterances were short, and grammatical morphemes were generally omitted. Children at later stages had more diverse vocabularies and produced longer utterances with more grammatical morphemes.