Examining Factors Associated with Primary Care and Continuity of Care Among Adults with Severe Mental Illness

A number of studies have consistently reported that there is a greater prevalence of mental illness among the most socioeconomically disadvantaged. At the same time, there is evidence that services are not optimally accessed by the most socioeconomically disadvantaged; the most in need of care are also the most likely to have unmet healthcare needs. Of people with mental illnesses, those with severe mental illnesses (SMI) are the most at risk of poverty and the least likely to have optimal care. In the past, specialized community mental health services have been identified as the primary provider for people with SMI. However, there is growing interest in using the primary care setting as the main source of mental health care where both medical treatment and psychotherapy can be accessed. In this paper, we examine factors related to primary care use (and in turn, pharmacologic and psychotherapies) for people who are socioeconomically disadvantaged and who have a SMI.     

Perceptions of personal sex discrimination: the role of belief in a just world and situational ambiguity

The roles of belief in a just world (BJW) and discrimination against ones' group in perceptions of personal discrimination were examined. Female participants (n = 63) were personally discriminated against in a laboratory setting. We manipulated whether the experimenter appeared to discriminate against other participants, which presumably made the presence of personal discrimination less ambiguous, or did not appear to discriminate against others, which presumably made personal discrimination more ambiguous. In the no group discrimination condition, but not in the group discrimination condition, participants' perceptions of being personally discriminated against depended on individual differences in BJW: Women with a strong BJW perceived less personal discrimination than those with a weak BJW. Also, strong BJW women in the group discrimination condition perceived less personal discrimination than strong BJW women in the no group discrimination condition.     

Co-Constructions of Gender and Ethnicity in New Zealand Television Advertising

This paper reports key findings from a content analysis of gender and ethnic depictions in a sample of 2,120 New Zealand prime-time television advertisements screened in 2006. The study explored the following questions: With what product categories are male and female White, Māori/Pasifika and Asian characters most commonly associated? What are the most common occupational roles of male and female White, Māori/Pasifika and Asian characters? The results reveal highly stereotypical depictions of women and men within each ethnic category. White men dominated advertisements for foodstuffs, telecommunications and financial/corporate/legal services and were over-represented as professionals/white collar workers, while White women were over-represented in advertisements for household products, personal products, and medical products and featured predominantly as homemakers. Māori/Pasifika men were over-represented as athletes and service and sales workers. Non-White women featured prominently within multi-ethnic groups in advertisements for personal grooming products and most frequently featured as glamour models, while non-White men were over-represented as blue collar workers. Largely absent were Māori/Pasifika women and Asians of both genders, potentially exacerbating the multiple axes of subordination encountered by these groups in the New Zealand context.     

Empathy development from 8 to 16 months: early signs of concern for others

The study examined the responses of typically developing infants to the distress of another, prior to and following the transition to the second year. Infants’ responses to maternal simulations of distress and to a peer distress videotape were observed from 8 to 16 months, using an accelerated longitudinal design (overall n = 37). Modest levels of affective and cognitive empathy for another in distress were already evident before the second year, and increased gradually (and not always significantly) across the transition to the second year. Prosocial behavior was rare in the first year and increased substantially during the second year. Self-distress reactions were rare overall. Individual differences in cognitive and affective empathy assessed in the first year, particularly at 10-months, predicted the levels of prosocial behavior observed in the second year. No gender differences were found. Theoretical implications and future research directions are discussed.     

Stress in telephone helpline nurses is associated with failures of concentration,attention and memory,and with more conservative referral decisions

Nurses working for telephone‐based medical helplines must maintain attentional focus while quickly and accurately processing information given by callers to make safe and appropriate treatment decisions. In this study, both higher levels of general occupational stress and elevated stress levels on particular shifts were associated with more frequent failures of attention, memory, and concentration in telephone nurses. Exposure to a stressful shift was also associated with a measurable increase in objectively assessed information‐processing errors. Nurses who experienced more frequent cognitive failures at work made more conservative decisions, tending to refer patients on to other health professionals more often than other nurses. As stress is associated with cognitive performance decrements in telephone nursing, stress‐reduction interventions could improve the quality and safety of care that callers to medical helplines receive.     

Latent Profile Analysis of Observed Parenting Behaviors in a Clinic Sample

We examined typologies of parenting practices using latent profile analysis (LPA) in a sample of families with young children who had externalizing behavior disorders. We also examined mother and child characteristics associated with class membership using ratings from multiple informants. The sample included pooled data from five parenting treatment outcome research studies on oppositional defiant disorder (ODD) and/or conduct disorder (CD) conducted throughout the past 20 years. These studies included 21 separate cohorts of children resulting in a total of 514 families. All children met diagnostic criteria for ODD or CD and 78 % were male. Parenting practices were observed by independent raters using the Dyadic Parent–child Interactive Coding System-Revised (DPICS-R). Four summary scores (i.e., total critical statements, total commands, total positive, total supportive) from the DPICS-R were used as class indictors in the LPA. Four classes best characterized the parenting practices of this clinic sample, roughly comprising a quarter of the sample each: Positive Only, Negative Only, Positive/Negative, and Neither Positive/Negative. High observed child negative behaviors, low observed child warmth, high socioeconomic status, and low academic performance distinguished the two classes with high negative behaviors (Negative Only, Positive/Negative) from the other classes. These results provide markers of the most common parenting profiles at entry into treatment programs for behavior disorders in young children. Findings have significant implications for the tailoring parenting interventions and supports to specific family needs.     

Ethnically based rejection sensitivity and academic achievement: The danger of retracting into one's heritage culture

This study examined the relation between ethnically based rejection sensitivity and academic achievement in a sample of 936 immigrant students in Germany and Switzerland. The theory of race‐based rejection sensitivity that originated in North America was extended to immigrant students in Europe. The rough political climate against immigrants in Europe makes it probable that immigrant youth face particular difficulties and are affected by ethnically based rejection sensitivity, at least as much as—or even more than—minority youth in the United States. Using a standardized literacy performance test and multilevel analyses, we found that ethnically based rejection sensitivity was negatively related to academic achievement for immigrant students. This relation was partially mediated by a strong contingency of the students' self‐worth on the heritage culture, as well as by a low number of native German or Swiss majority‐group friends. We interpret these processes as immigrant students' efforts to cope with ethnically based rejection sensitivity by retracting into their heritage culture and avoiding majority‐group contact, which unfortunately, however, at the same time also results in lower academic achievement. Copyright © 2014 John Wiley & Sons, Ltd.     

Threats to the Internal Validity of Spinal Surgery Outcome Assessment: Recalibration Response Shift or Implicit Theories of Change?

A recalibration response shift will cause the patient to think about a self-report measure’s response options differently after a health state change. Commonly assessed using the retrospective-pretest design (“then-test”), recent guidelines suggest adjusting then-test estimates for competing explanations. This prospective longitudinal study investigated recalibration response shift after adjusting for implicit theories of change in patients undergoing spinal surgery. The Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were collected before surgery and at 6 weeks and 3 months after spinal decompression surgery. Then-tests of the measures were also collected at all post-tests. Recalibration response shift was operationalized as the then-minus-pre difference score on the evaluative SF-36. Implicit theories of change were operationalized as the then-minus-pre difference score on the perception-based ODI. Improved vs. No-Effect patient groups were compared using the Minimally Important Difference (±15 points) as a cut-off on the Visual Analogue Scale (VAS) items for back and leg pain. Logistic regression analyses investigated whether recalibration response shift had an independent effect distinguishing patient groups, after adjusting for implicit theories of change. The sample (baseline n?=?169, mean age 52, 39 % female) was well-educated, and 1/3 were working. All then-minus-pre difference scores were non-zero at each time point and were stable over time. In the adjusted models distinguishing Improved versus No Effect groups, then-minus-pre ODI difference scores were significant in the majority of the adjusted models at all timepoints, but only one then-minus-pre SF-36 difference score—for physical functioning recalibration—was significant and only at 6-weeks post-surgery. This suggests that implicit theories of change bias the estimation of post-surgical outcomes, but that recalibration response shift biased only the estimation of physical functioning and only at 6 weeks post-surgery. Recalibration response shift and implicit theories of change can both be sources of bias in patient-reported outcome assessment. Our findings suggest that implicit theories of change are a greater threat to validity in this patient sample. Future research using the then-test should control for implicit theories of change to minimize misspecification of effects.