Marital Status and Outcome in Patients with Coronary Heart Disease

The purpose of this study was to examine the relationship of marital status to health outcomes in 818 post-MI, coronary artery bypass surgery, and angioplasty patients (651 males, 157 females) from seven Northern California hospitals who completed 12 months of a nurse-managed, home-based multifactorial risk reduction program. Compared to married patients, nonmarried patients were significantly less likely to complete the program than married patients, more likely to smoke at baseline, and drank significantly less alcohol at baseline. At 12 months there were no significant differences between married and nonmarried groups on smoking cessation rates, HDL, LDL, triglycerides, or exercise treadmill test results. When patients were categorized as married, divorced, separated, widowed, or single, similar results were found for the analyses using two groups (married versus nonmarried), with the following exceptions. Separated patients were significantly less likely to quit smoking. In addition, separated patients showed significantly higher rates of starting (and continuing) to smoke during the time following their MI. Mortality was not significantly different between married and unmarried patients. Implications for intervention with separated patients and the importance of assessing both marital status and marital quality are discussed.     

Use of the MMPI-2 With Chicanos: Strategies for Counselors

The Minnesota Multiphasic Personality Inventory–2 (MMPI-2) is frequently used by professional counselors to assess Chicano or Mexican American clients in various mental health settings. It is important to understand how ethnic and sociocultural variables (e.g., ethnic identity, acculturation, or racism) may influence the assessment process. This article presents strategies for the culturally competent use of the MMPI-2 with this burgeoning Hispanic subpopulation.     

Psychiatric Disorders Associated with Substance Use Among Children and Adolescents: Findings from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study

The relationships between specific quantities and frequencies of alcohol, cigarette, and illicit substance use and substance use (SUD) and other psychiatric disorders were investigated among 1,285 randomly selected children and adolescents, aged 9 to 18, and their parents, from the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study. Logistic regressions indicated that daily cigarette smoking, weekly alcohol consumption, and any illicit substance use in the past year were each independently associated with an elevated likelihood of diagnosis with SUD and other psychiatric disorders (anxiety, mood, or disruptive behavior disorders), controlling for sociodemographic characteristics (age, gender, ethnicity, family income). The associations between the use of specific substances and specific psychiatric disorders varied as a function of gender.     

The right-hemisphere bias in conditional reasoning: A short report on multiple failures to replicate previous findings

Summary The present set of studies attempted to replicate Gellatly's (1985) findings that were supportive of Evan's (1982) hypothesis that the right hemisphere produces a selective bias towards the incorrect solution of a complex reasoning task. Subjects solved problems of the form if p then q. In four studies, participants simultaneously performed a bottle - balancing task on each hand to interfere with processing of the reasoning task in the right hemisphere. In the fifth study, the bottle - balancing task was replaced by a finger - sequencing task. The results of the five studies did not show that the interference with right-hemisphere activity resulted in better performance on the conditional-reasoning task. It is concluded that the hypothesis of a right-hemisphere bias in conditional reasoning is still in need of reliable findings.     

Refraining Resistance and Noncompliance in Cognitive Therapy

Despite its general success, not everyone responds to cognitive therapy. Some clients have difficulty complying with assignments and others appear to be frankly resistant. This article considers strategies for dealing with passive noncompliance and active resistance within cognitive therapy. In general, it is argued that the process of therapy is usually facilitated by staying within the cognitive model—that is, by exploring and working through those beliefs and attitudes that underlie noncompliance and resistance in the same manner that other problematic beliefs and attitudes are approached. Also considered are strategies for dealing with unrealistic expectations regarding the pace of change, therapists' errors leading to noncompliance and resistance, and instances in which the therapeutic model is simply insufficient.     

‘Learning From’ the Concept and Concepts of a Religious Tradition: Jainism in the RE curriculum

Against a background of recent developments in religious education in England, this article argues for the inclusion of Jainism in the RE curriculum. Questions of the representation of religion in general and Jainism in particular are examined. It is claimed that when it comes to the ‘personal development’ side of religious education ('learning from'), pupils may best be served by drawing on a wider range of traditions than is customary in English RE, and that pupils need to engage with the ideas in a religious tradition as well as gain an authentic picture of the lives of practitioners. It is argued that much of personal and spiritual value can be gained from even an imperfect construction of a religious tradition, and this is illustrated from some of the teachings of Jainism and the author's experience of approaching a less familiar tradition.     

Short term forgetting in the absence of proactive interference

It has been claimed that the short-term forgetting shown by the Peterson technique is entirely due to proactive interference from prior experimental items. Two experiments investigated this by studying forgetting when prior items were avoided by testing subjects only once. Both experiments showed significant forgetting, although the degree of forgetting was less than with a multitrial procedure. On the basis of this and other results it is suggested that the Peterson technique comprises two components, a primary memory component which decays within 6 sec, and a more stable secondary memory component. Forgetting with the multitrial procedure is attributed principally to the need to use temporal retrieval cues to avoid confusion between successive items; longer retention intervals are associated with reduced temporal discriminability and hence poorer recall.     

Compounding vulnerability: pregnancy and schizophrenia

The predominant ethical framework for addressing reproductive decisions in the maternal-fetal relationship is respect for the woman's autonomy. However, when a pregnant schizophrenic woman lacks such autonomy, healthcare providers try to both protect her and respect her preferences. By delineating etic (objective) and emic (subjective) perspectives on vulnerability, I argue that options which balance both perspectives are preferable and that acting on etic perspectives to the exclusion of emic considerations is rarely justified. In negotiating perspectives, we balance the etic commitment to protect the vulnerable patient and her fetus from harm with the emic concern to empower a decisionally incapacitated woman. Equilibrium is best achieved by nurturing interdependent relationships that empower and protect the vulnerable woman. The analysis points to the need for better social support for mentally ill patients.     

Liability of professional and volunteer mental health practitioners in the wake of disasters: a framework for further considerations

Qualified immunity from civil liability exists for acts of disaster mental health (DMH) practitioners responding to disasters or acts of terrorism. This article reviews current legal regimens dictating civil liability for potentially wrongful acts of DMH professionals and volunteers responding to disasters. Criteria are proposed to inform determinations of civil liability for DMH workers in disaster response, given current legal parameters and established tort law in relevant areas. Specific considerations are examined that potentially implicate direct liability of DMH professionals and volunteers, and vicarious liability of DMH supervisors for actions of volunteer subordinates. The relevance of pre-event DMH planning and operationalization of the plan post-event is linked to considerations of liability. This article concludes with recommendations to minimize liability exposure for DMH workers in response efforts.     

Relationship of Attachment Style to Personality Factors and Family Interaction Patterns

This study investigated the relationships among attachment, personality style, and family interaction patterns. The results revealed that avoidant attachment style was associated with indirect affect expression as measured by somatic complaints, social isolation, family disengagement, and family conflict avoidance. Anxious/ambivalent style was associated with more overt expression of depression and anxiety. Family factors were not significantly related to either the anxious/ambivalent or secure styles. The implications and potential therapy benefits for use of attachment theory in family therapy and directions for future research are also addressed. Marci Leveridge, PhD, is a Licensed Health Service Provider and private practitioner in Oklahoma City. Cal Stoltenberg, PhD, is Professor, Counseling Psychology Program, University of Oklahoma, Department of Educational Psychology, 820 Van Vleet Oval, Room 321, Norman, OK 73019-2041 (cstoltenberg@ou.edu). Denise Beesley, PhD, is an Assistant Professor in the Counseling Psychology Program at the University of Oklahoma.