Sleep Symptoms as a Partial Mediator Between Combat Stressors and Other Mental Health Symptoms in Iraq War Veterans

Sleep symptoms are a prominent feature of mental health disorders like PTSD and depression. However, it is unknown whether sleep symptoms mediate the relationship between combat stress and these disorders. We examined the mediating role of sleep symptoms on the relationship between combat stress and PTSD; and the relationship between combat stress and depression using data from 576 Army veterans of the Iraq War surveyed in 2004. Correlational analyses revealed that when insomnia was included in the model, the correlation between combat stressors and other depression symptoms decreased by 65%; and when nightmares were included in the model, the correlation between combat stressors and other PTSD symptoms decreased by 69%. We replicated these analyses using individual items assessing PTSD and depression and found that the insomnia and nightmare items had the largest and second largest mediation effect between combat stressors and PTSD and depression symptoms. Our result support the theory that sleep symptoms contribute to the development and/or maintenance of other mental health symptoms and that early treatment of sleep symptoms may mitigate the other mental health consequences of combat stress.     

Cautionary Remarks on the Use of Clusterwise Regression

Clusterwise linear regression is a multivariate statistical procedure that attempts to cluster objects with the objective of minimizing the sum of the error sums of squares for the within-cluster regression models. In this article, we show that the minimization of this criterion makes no effort to distinguish the error explained by the within-cluster regression models from the error explained by the clustering process. In some cases, most of the variation in the response variable is explained by clustering the objects, with little additional benefit provided by the within-cluster regression models. Accordingly, there is tremendous potential for overfitting with clusterwise regression, which is demonstrated with numerical examples and simulation experiments. To guard against the misuse of clusterwise regression, we recommend a benchmarking procedure that compares the results for the observed empirical data with those obtained across a set of random permutations of the response measures. We also demonstrate the potential for overfitting via an empirical application related to the prediction of reflective judgment using high school and college performance measures.     

Day of a Cat's Death

Omnibus book review Robin Robertson The Place of the Feminine in the World to Come

Quantum Reality. By Nick Herbert. New York: Anchor Press/Double Day, 1985.

Synchronicity: The Bridge Between Matter and Mind. By F. David Peat. New York: Bantam Books. 1987.

Psyche Speaks. By Russell Lockhart. Wilmette, Illinois: Chiron, 1987.

The Scapegoat Complex: Toward a Mythology of Shdow and Guilt. By Sylvia Brinton Perera. Toronto: Inner City Books, 1986.

The Strange Trial of Mr. Hyde: A New Look Into the Nature of Human Evil. By John A. Sanford. San Francisco: Harper &; Row, 1987.

Perestroika: New Thinking for Our Country and the World. By Mikhail Gorbachev. New York: Harper &; Row, 1987.

The Jungian Experience: Analysis and Individuation. By James A. Hall, M.D. Toronto: Inner City Books, 1986.

Practical Jung: Nuts and Bolts of Jun-gian Psychotherapy. By Harry A. Wilmer. Wilmette, Illinois: Chiron Publications, 1987.

Psychiatry and the Cinema. By Krin Gabbard and Glen O. Gabbard. Chicago: University of Chicago Press, 1987.

Female Authority: Empowering Women Through Psychotherapy. By P. Young-Eisendrath and F. Wiedemann. New York Guilford Press, 1987.

Dancing Healers: A Docfor's Journey of Healing with Native Americans. By Carl Hammerschlag. San Francisco: Harper &; Row, 1988.

Neuroimmune Interactions: Proceedings of the Second International Workshop of Neuroimmunomodulation. Edited by Bronislav D. Jankovic Branislav M. Markovic, and Novera Herbert Spector. New York: The New York Academy of Sciences, 1987.     

One wage of unknowability

This article argues against fallibilist evidentialism on the basis of considerations about knowability.     

Work strain and the post-discharge adjustment of patients following a heart attack

Abstract

The role of work characteristics in determining return to work after an acute coronary event was examined. One hundred and forty nine patients were enrolled. One year post-discharge, 74 had returned to work. Work characteristics (decision latitude, and opportunity for social interaction at work), together with age, depression, and medical prognosis, correctly classified work status in 78% of cases. At 12 months post-discharge, patients who had not returned to work recorded significantly poorer levels of adjustment compared to those who had returned to work. A better quality of life is associated with a lower level of depression pre-hospitalization, ownership of a larger home, being male, and having a more positive work environment. The findings suggest that the pre-illness work environment of the patient is a factor influencing return to work, which needs to be considered in rehabilitation programmes.     

the relationship between pain and coping styles among hiv-positive men and women

Abstract

Pain in HIV/AIDS patients is associated with compromised quality of life and emotional adjustment. Although previous findings support a relationship between coping styles and subjective pain for various groups of chronically-ill persons, little research has examined the associations between coping and pain in HIV-positive or AIDS patients. The purpose of this study was to explore the relationship between pain and coping styles among 105 HIV-positive participants (32 women and 73 men) in a randomized clinical trial designed to examine the effect of group psychotherapy on quality of life and health behavior. Participants completed the Brief COPE, the pain scale from the Medical Outcomes Study-HIV, and a demographic and medical questionnaire. Multiple regression analysis, with pain as the dependent variable, showed that participants who reported coping through denial reported greater pain severity (p < 0.0001). These results suggest that denial as a coping strategy appears to be signficantly associated with pain for persons with HIV/AIDS. However, further research is necessary to determine the causal relationship between pain and coping through denial. These findings also point to the possibility of psychological intervention in order to modify maladaptive coping styles and to ameliorate pain in this population.     

Recognition of Affective Speech Prosody and Facial Affect in Deaf Children with Unilateral Right Cochlear Implants

Cochlear implant (CI) devices provide the opportunity for children who are deaf to perceive sound by electrical stimulation of the auditory nerve, with the goal of optimizing oral communication. One part of oral communication concerns meaning, while another part concerns emotion: affective speech prosody, in the auditory domain, and facial affect, in the visual domain. It is not known whether childhood CI users can identify emotion in speech and faces, so we investigated speech prosody and facial affect in children who had been deaf from infancy and experienced CI users. METHOD: Study participants were 18 CI users (ages 7–13 years) who received right unilateral CIs and 18 age- and gender-matched controls. Emotion recognition in speech prosody and faces was measured by the Diagnostic Analysis of Nonverbal Accuracy. RESULTS: Compared to controls, children with right CIs could identify facial affect but not affective speech prosody. Age at test and time since CI activation were uncorrelated with overall outcome measures. CONCLUSION: Children with right CIs recognize emotion in faces but have limited perception of affective speech prosody.     

Diabetes Self-Management Profile Short Form: A Preliminary Report

Effective family management of type 1 diabetes in childhood is critical to maintaining optimal glycemic control. The purpose of this study was to provide preliminary evidence for a reduced form of the Diabetes Self-Management Profile (DSMP) using Rasch modeling techniques. The study was a secondary analysis of DSMP data drawn from a previous study on patterns of self-management from 239 preadolescents with type 1 diabetes. Rasch modeling strategies were used to identify the most informative items and then a reduced score composite was correlated with hemoglobin A1c (A1c) and blood glucose monitoring (BGM) frequency. A short form of the DSMP was obtained using seven items that comprised all five subscales of the DSMP. The DSMP Short-Form (DSMP-SF) composite score correlated significantly with child’s HbA1c and BGM frequency. The DSMP-SF may be considered a valid and effective screening interview alternative to the longer, original, DSMP, particularly when attempting to identify high-risk patients.