On the aims of medicine: Comments on ‘philosophy of medicine as the source for medical ethics’

Health defined as the psychophysiological capacity to act or respond appropriately in a wide variety of situations, is enhanced by many means other than preventing and treating disease and injury. Therefore no choice of a particular medical intervention is likely to maximize health for all people with (or at risk for) a given disease. As a result, if medical practitioners are to be fully competent in the sense of knowing not only how to perform procedures but when and when not to do so, they must be able to support patients (and those who know and care about them) in weighing all of the many factors which bear upon the decision as to which, if any, medical interventions are likely to improve the person's health.     

Chinese participation in the church of Jesus Christ of latter‐day saints (Mormons) in Hong Kong

This paper shows how both intellectual and social factors motivate and sustain Chinese participation in the Church of Jesus Christ of Latter‐day Saints (Mormons) in Hong Kong. The data was collected from February 1996 to November 1997. Particular emphasis is placed on understanding how Chinese Mormons experience their church membership. My results show a positive relation between sustained church participation and pre‐Mormon religious involvement that has points of crucial similarity.     

Adult sex role orientation and perceptions of aggressive interactions between girls and boys

We explored how the sex role orientation of adult observers related to their perceptions of boys' and girls' aggression. Sex-typed and androgynous undergraduate subjects viewed videotaped scenes in which one member of a girl-boy pair behaved aggressively toward the other. Unlike androgynous subjects, sex-typed subjects judged boys' aggression to be more intentional than girls' and proposed more severe reprimands for aggressive boys than for aggressive girls. Androgynous subjects recommended more severe reprimands for aggressive girls than sex-typed subjects did. Overall, sex-typed subjects differed from androgynous subjects not in their assessment of the degree of aggressiveness boys and girls expressed, but in their perceptions of the purposefulness of boys' and girls' aggression and how harshly to respond to it. We speculated that sex-typed subjects did not consider girls' aggression to be serious enough to warrant severe reprimands. Thus, during socialization, sex-typed adults perhaps model less aggression in response to girls' aggressive acts than to boys'. In addition, sex-typed adults may convey to girls that their aggression is not an effective means of obtaining adult intervention.     

Comparison of outcomes across low-intensity psychological interventions for depression and anxiety within a stepped-care setting: A naturalistic cohort study using propensity score modelling

Low-intensity interventions for common mental disorders (CMD) address issues such as clinician shortages and barriers to accessing care. However, there is a lack of research into their comparative effectiveness in routine care. We aimed to compare treatment effects of three such interventions, utilizing four years' worth of routine clinical data. Users completing a course of guided self-help bibliotherapy (GSH), internet-delivered cognitive behavioural therapy (iCBT) or psychoeducational group therapy (PGT) from a stepped-care service within the NHS in England were included. Propensity score models (stratification and weighting) were used to control for allocation bias and determine average treatment effect (ATE) between the interventions. 21,215 users comprised the study sample (GSH = 12,896, iCBT = 6862, PGT = 1457). Adherence-to-treatment rates were higher in iCBT. All interventions showed significant improvements in depression (PHQ-9), anxiety (GAD-7) and functioning (WSAS) scores, with largest effect sizes for iCBT. Both propensity score models showed a significant ATE in favour of iCBT versus GSH and PGT, and in favour of GSH versus PGT. Discernible differences in effectiveness were seen for iCBT in comparison with GSH and PGT. Given variance in delivery mode and human resources between different low-intensity interventions, building on these findings would be valuable for future service provision and policy decision making.     

An investigation of neuronal integrity in severe paediatric traumatic brain injury.

Magnetic Resonance Spectroscopy (MRS) and its association with neuropsychological functioning was examined in the chronic injury phase of paediatric traumatic brain injury (TBI). Fifteen children, aged 10-16 years, with severe TBIs were compared with 15 controls, matched for age and gender. The TBI group was found to have significantly lower levels of -acetyl aspartate (NAA) and Choline (Cho) in the right frontal lobe and generally displayed reduced performances on neuropsychological tests. A correlation between metabolites and reaction times was also obtained. Findings indicate a role of proton MRS as a measure of neuronal integrity following severe paediatric TBI and suggest a potential association of MRS with specific neuropsychological impairments.     

The mediating effect of adaptive and maladaptive emotion regulation strategies on executive functioning impairment and depressive symptoms among adolescents

Past research results suggest that executive functioning (EF) impairment represents an important vulnerability factor in depression. Little research, however, has examined mechanisms underlying this association. The current study investigates the associations between EF impairment, emotion regulation (ER) strategies, and depressive symptoms in a sample of 579 adolescents (320 females, mean age = 12.06 years). Parents reported on adolescents’ EF and general psychopathology, and adolescents self-reported ER strategies and depressive symptoms. The results indicate that greater EF impairment is associated with more depressive symptoms. Youth with greater EF impairment reported more maladaptive ER and less adaptive ER, and maladaptive and adaptive ER strategies jointly mediated the association between EF impairment and depressive symptoms. The results highlight an important role of both maladaptive and adaptive ER in explaining the relationship between EF and depressive symptoms and suggest that clinical interventions targeting ER skills may provide one strategy for the prevention and treatment of depression. Further longitudinal research is needed to replicate these results and evaluate the causality of the relations.     

Posttraumatic growth following pregnancy termination for fetal abnormality: the predictive role of coping strategies and perinatal grief

Background: Research about termination for fetal abnormality (TFA) suggests that it is a traumatic event with potential negative psychological consequences. However, evidence also indicates that following traumatic events individuals may experience growth. Although TFA’s negative psychological outcomes are well documented, little is known of the potential for growth following this event. Therefore, the study’s objectives were to measure posttraumatic growth (PTG) post-TFA, examine the relationship between PTG, perinatal grief and coping, and determine the predictors of PTG.

Design: An online, retrospective survey was conducted with 161 women.

Methods: Eligible participants were women over 18 who had undergone TFA. Participants were recruited from a support organisation. They completed the Brief COPE, Short Perinatal Grief Scale and Posttraumatic Growth Inventory. Data were analysed using regression analyses.

Results: Moderate levels of PTG were observed for “relating to others,” “personal strengths” and “appreciation of life.” “Positive reframing” was a significant predictor of PTG. Despite using mainly “adaptive” coping strategies, women’s grief levels were high.

Conclusions: “Adaptive” coping strategies such as, “positive reframing” are relevant to TFA. They may act as protective factors against distress and as foundations for growth, implicating that interventions such as Cognitive Behavioural Therapy, which aim to reframe women’s experience, may be beneficial.     

Stigma towards Mental Health Problems during Childhood and Adolescence: Theory,Research and Intervention Approaches

Many children and teenagers living with mental health problems experience stigma from within their peer group, yet this remains an under-researched topic in developmental science and the broader mental health literature. This paper highlights the limitations of adopting measures, concepts and theories that have exclusively emanated from the adult mental health literature. We argue that the social context of children and adolescents is critical in understanding the development and maintenance of stigma towards those with mental health problems, alongside the changing developmental needs and abilities of children and adolescents. In this article we argue that a theory proposed to explain the development of stereotypes and prejudice in childhood has potential as a framework for integrating existing research findings on mental health stigma in childhood and adolescence and providing direction for further research. The need for interventions that are grounded within the developmental science literature and that explicitly state their theory of change are identified as key research priorities for reducing stigma during childhood and adolescence.