Spiritual Beliefs and Barriers Among Managed Care Practitioners

Purpose: Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Methods: Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Findings: Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patients spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physicians role. Ninety-five percent of our managed care group noted 8lack of time as an important barrier, lack of training was indicated by 69%, and 21% cited fear of response from administration. Conclusions: Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients expressed needs regarding spirituality and beliefs.*This material has previously been presented as an abstract at the Culture and End of Life Conference, Association of Medical Colleges Spirituality, Kansas City, MO, September 12–14, 2002.Project supported by the Foundation for Spirituality in Medicine, Baltimore, MD     

Deliberate control of continuous motor performance

The authors examined the means by which people vary movement parameters to satisfy more than 1 constraint at a time in a repetitive motor task. The authors expected that when participants (N = 12) were simultaneously confronted with spatial and temporal constraints in an ellipse-drawing task, they would either exploit the intrinsic amplitude-frequency relationships or activate less natural control regimes to prioritize their movement goals. By focusing on local amplitude and frequency errors and parameter changes from 1 movement to the next, the authors distinguished parameter changes that reflected exploitation of biomechanics from those that required deliberate control. The findings demonstrated that at low movement speeds, participants can pursue multiple movement goals simultaneously; at higher speeds, their capacity to satisfy multiple task goals is reduced. The authors used a new method of inferring deliberate control from movement kinematics in the present study.     

Parenting Competency Across Pregnancy and Postpartum Among Urban Minority Women

Taking a life-course perspective, we explored the sense of parenting efficacy during the pregnancy-postpartum transition among a group under-represented in much of adult developmental research, minority women. Our intent was to describe the women's report of parenting competency in a major life transition occurring within the context of an impoverished urban environment. We also explored associations with depression, social support, and life events. One hundred and eighty-two African-American and Hispanic mothers at community health centers in low-income urban areas completed measures early in the third trimester and again at 3 months postpartum. Across time, the levels of reported parental efficacy and satisfaction increased while depressive symptoms decreased. Negative life events and levels of depressive symptomatology differentially influenced women's experience of parenting satisfaction and efficacy feelings before and after their babies were born.     

Psychology at the intersection of work and family: recommendations for employers, working families, and policymakers

Demographic data show that major changes have been occurring in the everyday lives of families over the last generation, with the majority of mothers of young children in the workforce and an increasing number of men and women assuming caregiving responsibilities for older relatives. Thus, the 2 primary identities of most adults, defined by their multiple family and work roles, need to be coordinated in ways that promote positive family outcomes, returns on investments for employers, and societal values. Despite changes in the workforce, the world of work is still largely organized for a family model that is increasingly rare--one with a stay-at-home caregiver. Recommendations based on psychological and other social science research are offered to align the needs of working families and employers.     

Positivity can cue familiarity

Given that familiarity is closely associated with positivity, the authors sought evidence for the idea that positivity would increase perceived familiarity. In Experiment 1, smiling and thus positively perceived novel faces were significantly more likely to be incorrectly judged as familiar than novel faces with neutral expressions. In Experiment 2, subliminal association with positive affect (a positively valenced prime) led to false recognition of novel words as familiar. In Experiment 3, validity judgments, known to be influenced by familiarity, were more likely to occur if participants were in happy mood states than neutral mood states. Despite their different paradigms and approaches, the results of these three studies converge on the idea that, at least under certain circumstances, the experience of positivity itself can signal familiarity, perhaps because the experience of familiarity is typically positive.     

Auditory repetition priming is impaired in pure alexic patients

Alexia without agraphia, or "pure" alexia, is an acquired impairment in reading that leaves writing skills intact. Repetition priming for visually presented words is diminished in pure alexia. However, it is not possible to verify whether this priming deficit is modality-specific or modality independent because reading abilities are compromised. Hence, auditory repetition priming was assessed with lexical decision and word stem completion tasks in pure alexic patients with lesions in left inferior temporal-occipital cortex and the splenium. Perceptually based, modality-specific priming models predict intact auditory priming, since auditory association cortex is spared in the patients. Alternatively, modality-independent models, which suggest that priming reflects the temporary modification of an amodal system, might predict impairments. Baseline performance was matched in the patients and controls, although lexical decision priming measures showed an interaction between group and repetition lag. The patients showed intact immediate priming but significantly less priming than controls at longer delays. Furthermore, word stem completion priming was abolished in the patients. One explanation for the deficit is that left inferior temporal-occipital cortex supports amodal aspects of priming, as suggested by recent neuroimaging results. Another possibility is that long-term auditory priming relies on covert orthographic representations which were unavailable in the patients. The results provide support for interactive models of word identification.     

Assessing worry in older adults: confirmatory factor analysis of the Penn State Worry Questionnaire and psychometric properties of an abbreviated model

The assessment of worry among older adults typically has involved measures designed with younger cohorts. Because of special concerns in assessing older adults, modifications to existing instruments may be necessary. Addressing equivocal factor analytic data on the Penn State Worry Questionnaire (PSWQ) among younger adults, the authors conducted confirmatory factor analyses to evaluate the generalizability of previous models to older adults with generalized anxiety disorder. Data fit poorly with established single- and two-factor models. The single-factor model was modified, resulting in the elimination of 8 items, strong fit indices, high internal consistency, adequate test-retest reliability, and good convergent and divergent validity. Further psychometric work is required to assess whether the revised model is a more parsimonious method to assess late-life anxiety.     

Correlates of African American and Latino parents' messages to children about ethnicity and race: a comparative study of racial socialization

Recently, social scientists have become increasingly interested in the nature of communications from parents to children regarding ethnicity and race. Termed racial socialization, race-related messages to children may have important consequences for children's identity development and well-being. This study examined the frequency and correlates of two dimensions of racial socialization—messages about ethnic pride, history, and heritage (Cultural Socialization) and messages about discrimination and racial bias (Preparation for Bias)—among 273 urban African American, Puerto Rican, and Dominican parents. Parents reported more frequent Cultural Socialization than Preparation for Bias. There were no significant ethnic group differences in the frequency of Cultural Socialization. However, African American parents reported more frequent Preparation for Bias than did Dominican parents who, in turn, reported more frequent messages of this sort than did Puerto Rican parents. Ethnic identity was a stronger predictor of Cultural Socialization among Puerto Rican and Dominican parents than among their African American counterparts. In contrast, perceived discrimination experiences was a stronger predictor of Preparation for Bias among African American and Dominican parents than among Puerto Rican parents. Finally, race-related phenomenon accounted for more variance in both Cultural Socialization and Preparation for Bias among parents reporting on their behaviors with children 10–17 years old as compared to parents reporting on their behaviors with children 6–9 years old.     

A cognitive profile of individuals who tend to worship celebrities

Celebrity worship is a form of parasocial interaction in which individuals become obsessed with 1 or more celebrities, similar to an erotomanic type of delusional disorder. Drawing on the cognitive factors implicated in erotomania, the authors hypothesized that celebrity worshippers might be expected to exhibit verbal, visuospatial, and cognitive deficits related to flexibility and associative learning. This general hypothesis was tested in a sample of 102 participants who completed the Celebrity Attitude Scale (L. E. McCutcheon, R. Lange, & J. Houran, 2002), the Entertainment-Social, Intense-Personal, and Borderline Pathological subscales, and 6 cognitive measures that included creativity (verbal), crystallized intelligence, critical thinking, spatial ability, and need for cognition. The results were consistent with predictions and suggest that cognitive deficits only help facilitate an individual's susceptibility to engage in celebrity worship. The results are discussed in terms of the multivariate absorption-addiction model of celebrity worship.