Diabetes Knowledge as a Moderator of Reactions to Illness by Patients With Insulin-Dependent Diabetes Mellitus1

We examined patient knowledge as a moderator of psychological reactions to illness among patients with insulin-dependent diabetes mellitus. We reasoned that knowledgeable patients would have the most severe reactions to their illness because the causal implications of good or poor metabolic control would be most apparent. Accordingly, we expected that more knowledgeable patients would react more negatively than less knowledgeable patients to poor metabolic control but would react more positively to good metabolic control. Results from a sample of 46 patients with insulin-dependent diabetes mellitus supported this hypothesis. These findings suggest that increased patient knowledge may not produce uniformly positive results. Patient education programs must consider the psychological implications of patient knowledge in addition to the physiological consequences.     

In Defense of a Worldly Separatism

In this response to Kathleen Martindale and Martha Saunders's “Realizing Love and Justice: Lesbian Ethics in the Upper and Lower Case,” which appeared in Hypatia 7(4), I argue that a worldly separatism depends upon taking attention from those in positions of dominance and redirecting it to members of nondominant groups, as apolitical, worldly act of resistance.     

CONTRIBUTORS TO STRESS RESISTANCE

This study integrated work-family research with the stress resource perspective and organizational leadership theory. Based on the premise that stress is a major contributor to work-family conflict, this research examined resources likely to reduce the stress and work-family conflict women experience. Family emotional support, leader-member exchange, and hardiness were explored as potential resources. The 206 participants were recruited in daycare centers, a business community, and a university setting. The sample was diverse in terms of ethnicity and occupation. However, the majority of the women were married (68%) with children (82%). Path analytic tests supported most of the relationships in the hypothesized model. Findings suggest that having a high-quality relationship with one's supervisor may have complex implications for work-family conflict.     

Valence and Arousal Ratings for Velten Mood Induction Statements

Participants rated 84 statements adapted from Velten's original mood induction statements—designed to induce positive and negative mood—on two dimensions of emotion (valence and arousal), using the Self Assessment Manikin (SAM) (P. J. Lang, M. M. Bradley, & B. N. Cuthbert, 1999). Fifty-two of these Velten positive, negative, and neutral statements yielded SAM valence ratings that were consistent with Velten's previous valence designation (E. Velten, 1968). Reliability analyses for the positive, negative, and neutral statements indicated a high level of internal consistency in the three statement groups. Arousal and valence ratings of the statements were positively correlated. Related issues concerning differences in rating verbal versus visual emotional stimuli and recommendations for future work to improve the validity of Velten's mood induction statements are addressed.     

The Contributions of Political Life Events to Psychological Distress Among South African

The psychological consequences of adverse political experiences among South African youth were studied in a sample of 540 black and white adolescents from two age groups, evenly divided by gender. Three questionnaires were administered, measuring exposure to political life events, the presence of symptoms of psychopathology, and stressful personal life events during the previous 5 years. The first hypothesis, predicting a substantial contribution of stressful political experiences to psychopathology, was strongly supported; when stressful personal life events were partialed out, a significant effect for political life events remained both on general distress and symptomatology indices. The second hypothesis of a linear relation between exposure to political life events and severity of distress was also confirmed. The findings underscore the enduring impact on children's mental health of past apartheid policies in South Africa specifically, and adverse political environments in general.     

Social isolation and gender

This study investigated the relationship between gender and social support. It was found that men were more isolated than women although there were no gender differences in perceived adequacy (i.e., satisfaction with one's social support network) or network size. Given that both the adequacy and network size variables were associated with socially desirable responding but the isolation variable was not, the results suggest that the behaviorally oriented indicator of isolation was a better measure of the degree of social isolation than traditional subjective scales currently used by many researchers. This suggests that traditional measures of social support that incorporate the dimensions of network size and perceived adequacy of one's social support system need to control for socially desirable responding and that measures can and need to be developed that are not significantly influenced by this response set bias. Hence, the assessment of social support may need to be more multifaceted than is currently undertaken in many studies. Our finding that men reported being more isolated than women may be a function, in part, of the fact that the majority of the sample (76.7%) was single/did not live with a partner. Previous research has found that men generally get their emotional needs met by their spouses/partners while women often get their emotional needs met by their female friends. Consistent with the literature, and given that most of our respondents were single, this study supports the contention that men are generally more socially isolated than women because they do not create adequate emotional intimacy when they are not in partnership with a significant other.     

Explanations: What Factors Enhance Their Perceived Adequacy?

Factors that enhance the perceived adequacy of explanations for bad news were examined in three studies: two cross-sectional surveys and a simulation experiment. All studies found that the specificity of the explanation′s substance accounted for more variance in judgments of explanation adequacy than did the interpersonal sensitivity of the explanation′s delivery. Moderators of the relationship between explanation features and perceptions of explanation adequacy were found as well: These explanation features enhanced the perceived adequacy of explanations more when outcomes of greater, rather than lesser, severity were being explained, and when the explanation was delivered verbally instead of in writing. Theoretical and practical implications are discussed.     

Weight suppression is a robust predictor of outcome in the cognitive-behavioral treatment of bulimia nervosa

This study examined weight suppression (difference between highest premorbid weight and pretreatment weight) as a predictor of outcome in 188 outpatients with bulimia nervosa enrolled in a cognitive-behavioral therapy intervention. Participants who dropped out of treatment had significantly higher levels of weight suppression than treatment completers. Of participants who completed treatment, those who continued to engage in binge eating or purging had significantly higher levels of weight suppression than those who were abstinent from bingeing and purging. Results did not change when body mass index, dietary restraint, weight and shape concerns, or other relevant variables were controlled. Relinquishing bulimic behaviors and adopting normal eating patterns may be most feasible for patients who are closest to their highest premorbid weights.     

Interrater reliability and coding guide for nonpsychotic formal thought disorder

Reliable and valid assessment of abnormal speech patterns may enable earlier recognition of nonpsychotic disorders through characteristic speech patterns. This study sought to establish interrater reliability using a standardized guide for scoring. A scoring guide defining 27 elements (e.g., inappropriate self-reference, simple loss of goal, circumstantiality) of disordered thought was developed. The seminal work of Andreasen's and Holzman's groups provided 12 elements, and 15 new elements were suggested by clinical literature. Audiotaped interviews with 12 psychiatric inpatients, adults of both sexes and various ages hospitalized for acute management of nonpsychotic psychiatric disorders, provided speech samples for observation of disordered thought by two independent raters. Using the guide's definitions and accompanying examples of elements of disordered thought, reliability in scoring was high (kappa of .85 for agreement on the presence of any abnormal speech element and kappa values from .66 to 1.00 for agreement on the presence of individual elements).