Are you ‘woman enough’ to control your leading cause of death?: an ethnographic content analysis of women’s cardiovascular disease and identities in media narratives

The Heart Truth^® campaign was implemented in the United States by the National Heart, Lung, and Blood Institute in 2002 to increase women’s awareness of heart disease and encourage risk reduction of cardiovascular disease. The present study explored representations of women’s cardiovascular disease, the meanings generated, and the implications for identity construction within one prominent corporate media partner of the campaign. The inaugural 2003 October issue of Glamour magazine was the focus of an ethnographic content analysis. Women’s cardiovascular disease was constructed within an overarching theme of a culture of consumerism, with meanings of cardiovascular disease emerging within two subthemes: (a) the oblivious, unknowledgeable, dependent woman at risk and (b) attaining a particular version of a healthy, feminine woman. Women’s identities were constructed as dependent on experts, purchasing fashion and fitness merchandise, and heteronormative roles for health management. These findings extend health psychology research that has called for more critical explorations of media to extend understandings of disease meanings and the implications for identity and women’s health.     

Understanding heterogeneity in borderline personality disorder: Differences in affective reactivity explained by the traits of dependency and self-criticism

This study examined whether the personality traits of self-criticism and dependency respectively moderated the effects of perceived inferiority and emotional insecurity on negative affect during interpersonal interactions in individuals with borderline personality disorder (BPD). A sample of 38 patients with BPD and matched community comparison participants completed event-contingent record forms after each significant interaction for a 20-day period. Multilevel models showed that, controlling for baseline levels of depressive symptoms and neuroticism, as well as lagged negative affect, event-level elevations in perceived inferiority and emotional insecurity were related to more negative affect in both groups. Event-level perceived inferiority was more strongly associated with negative affect in patients with BPD who reported higher levels of self-criticism, while event-level perceived emotional insecurity was more strongly associated with negative affect in patients with BPD who reported higher levels of dependency. No significant interactions emerged for the comparison group. These findings further our understanding of differences among patients with BPD and support the application of personality-vulnerability or diathesis-stress models in predicting negative affect in BPD. Results have implications for the design of therapies for patients with BPD. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Culture and the distinctiveness motive: constructing identity in individualistic and collectivistic contexts

The motive to attain a distinctive identity is sometimes thought to be stronger in, or even specific to, those socialized into individualistic cultures. Using data from 4,751 participants in 21 cultural groups (18 nations and 3 regions), we tested this prediction against our alternative view that culture would moderate the ways in which people achieve feelings of distinctiveness, rather than influence the strength of their motivation to do so. We measured the distinctiveness motive using an indirect technique to avoid cultural response biases. Analyses showed that the distinctiveness motive was not weaker-and, if anything, was stronger-in more collectivistic nations. However, individualism-collectivism was found to moderate the ways in which feelings of distinctiveness were constructed: Distinctiveness was associated more closely with difference and separateness in more individualistic cultures and was associated more closely with social position in more collectivistic cultures. Multilevel analysis confirmed that it is the prevailing beliefs and values in an individual's context, rather than the individual's own beliefs and values, that account for these differences.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 1: conceptual and definitional issues in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM - whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part I of this article will take up the first two questions. With the first question, invited commentators express a range of opinion regarding the nature of psychiatric disorders, loosely divided into a realist position that the diagnostic categories represent real diseases that we can accurately name and know with our perceptual abilities, a middle, nominalist position that psychiatric disorders do exist in the real world but that our diagnostic categories are constructs that may or may not accurately represent the disorders out there, and finally a purely constructivist position that the diagnostic categories are simply constructs with no evidence of psychiatric disorders in the real world. The second question again offers a range of opinion as to how we should define a mental or psychiatric disorder, including the possibility that we should not try to formulate a definition. The general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

Dewey Between the Lines: George Kelly and the Pragmatist Tradition

In his own somewhat sly and sardonic way, George Kelly always insisted that personal construct theory could not be assimilated into any other kind of psychology. We believe this was not an example of Kelly being difficult or protecting his turf, but that he resisted such efforts at categorization because he formulated personal construct psychology from an entirely different set of assumptions than those which have traditionally guided the construction of psychological theories. We begin by looking at the unusual life path Kelly took in order to enter the field of psychology and what it reveals about the independent turn of mind he brought to creating his own theory of personality. We then examine what we believe is the single most important influence on Kelly's thinking—the tradition of American pragmatism, in general, and the philosophy and psychology of John Dewey, in particular. We argue that Kelly embraced the pragmatic epistemological assumptions that guided Dewey's work, and that he used these assumptions to develop the only pragmatic theory of personality and psychotherapy. It is, in fact, the influence of Dewey and the pragmatists that makes personal construct psychology so different from and, at times, more difficult to understand than other, more traditional, “realist” theories, but it is also this pragmatic orientation that makes Kelly's theory such an important contribution.     

Correlates of religious,supernatural and psychosocial causal beliefs about depression among Latino immigrants in primary care

The purpose of this cross-sectional study was to explore causal attributions about depression and to identify psychosocial factors associated with these beliefs among Latino immigrants. We interviewed 177 primary care patients with instruments to assess causal beliefs, depressive and somatic symptoms, ethnic identity and stigma. An exploratory factor analysis of the Causal Beliefs scale yielded three factors, “Balance,” “Psychosocial” and “Malevolent Spirituality/Transgressions” that were used as dependent variables in multivariate analyses. Depressive symptoms, age, country of origin and religiosity were significantly associated with particular factors of causal beliefs. Those with higher education were most likely to endorse psychosocial causal beliefs. Stigma pertained to causal beliefs related to “malevolent forces” and “personal transgressions.” In conclusion, psychosocial and religious explanations of illness were strongly endorsed by these Latino immigrants, indicating a dual system of Western-medicine and traditional beliefs. These results suggest culturally-specific interventions for improving health knowledge and communication with patients about depression.     

Endophenotypes and the diagnosis of personality disorders

It has been suggested that psychiatric diagnosis should come to depend on endophenotypes, in order to define more precisely the mechanisms behind mental disorders. This construct is associated with the assumption that mental processes can be reduced to activity at a neuronal level. The approach has had a strong influence on the conceptual basis of proposals for DSM-5, but could be consistent either with categorical or dimensional diagnosis. However, application of endophenotypes to personality disorders is unlikely for the foreseeable future, given an insufficient knowledge of etiology and pathogenesis.     

Interactive Links Between Theory of Mind,Peer Victimization,and Reactive and Proactive Aggression

This study investigated the relation between theory of mind and reactive and proactive aggression, respectively, as well as the moderating role of peer victimization in this context. The 574 participants were drawn from a longitudinal study of twins. Theory of mind was assessed before school entry, when participants were 5 years old. Reactive and proactive aggression as well as peer victimization were assessed a year later in kindergarten. Results from multilevel regression analyses revealed that low theory of mind was related to a high level of reactive aggression, but only in children who experienced average to high levels of peer victimization. In contrast, a high theory of mind was related to a high level of proactive aggression. Again, this relation was especially pronounced in children who experienced high levels of peer victimization. These findings challenge the social skills deficit view of aggression and provide support for a multidimensional perspective of aggressive behavior.     

Perceived group and personal discrimination: differential effects on personal self‐esteem

In two studies, we investigate the differential influence of perceived group and personal discrimination on self‐esteem in the context of the Rejection–Identification model (Branscombe, Schmitt, & Harvey, 1999 ). We first polled a group of African immigrants and found that whereas personal discrimination was negatively related to personal self‐esteem, group discrimination was positively associated with it. As expected, identification served as a buffer between personal discrimination and self‐esteem. We replicated these effects in a second study using women as our respondents. These results suggest that perceiving group discrimination may be positively related to self‐esteem because people feel less alone in their plight, thereby alleviating the ill‐effects of exclusion. We discuss these results in relation to both the Rejection–Identification model and the discounting hypothesis (Crocker & Major, 1989 ). Copyright © 2006 John Wiley & Sons, Ltd.