The medical traumatic stress toolkit

Children and their parents who are exposed to medical life-threat due to illness or injury are at risk for developing symptoms of posttraumatic stress. However, the prevention, detection, and treatment needed are often not available in the acute care settings of the hospital. The National Child Traumatic Stress Network and the Substance Abuse and Mental Health Services Administration have created a set of materials for use by hospital health providers and families that is available for download free from the National Child Traumatic Stress Network website, www.nctsn.org.     

A cascade of disparities: health and health care access for people with intellectual disabilities

People with ID represent approximately 2% of the population and, as a group, experience poorer health than the general population. This article presents recent conceptualizations that begin to disentangle health from disability, summarizes the literature from 1999 to 2005 in terms of the cascade of disparities, reviews intervention issues and promising practices, and provides recommendations for future action and research. The reconceptualization of health and disability examines health disparity in terms of the determinants of health (genetic, social circumstances, environment, individual behaviors, health care access) and types of health conditions (associated, comorbid, secondary). The literature is summarized in terms of a cascade of disparities experienced by people with ID, including a higher prevalence of adverse conditions, inadequate attention to care needs, inadequate focus on health promotion, and inadequate access to quality health care services. Promising practices are reviewed from the perspective of persons with ID, providers of care and services, and policies that influence systems of care. Recommendations across multiple countries and organizations are synthesized as guidelines to direct future action. They call for promoting principles of early identification, inclusion, and self-determination of people with ID; reducing the occurrence and impact of associated, comorbid, and secondary conditions; empowering caregivers and family members; promoting healthy behaviors in people with ID; and ensuring equitable access to quality health care by people with ID. Their broadscale implementations would begin to reduce the health disparity experienced by people with ID.     

When effect sizes disagree: the case of r and d

The increased use of effect sizes in single studies and meta-analyses raises new questions about statistical inference. Choice of an effect-size index can have a substantial impact on the interpretation of findings. The authors demonstrate the issue by focusing on two popular effect-size measures, the correlation coefficient and the standardized mean difference (e.g., Cohen's d or Hedges's g), both of which can be used when one variable is dichotomous and the other is quantitative. Although the indices are often practically interchangeable, differences in sensitivity to the base rate or variance of the dichotomous variable can alter conclusions about the magnitude of an effect depending on which statistic is used. Because neither statistic is universally superior, researchers should explicitly consider the importance of base rates to formulate correct inferences and justify the selection of a primary effect-size statistic.     

Lexically guided retuning of letter perception

Participants made visual lexical decisions to upper-case words and nonwords, and then categorized an ambiguous N-H letter continuum. The lexical decision phase included different exposure conditions: Some participants saw an ambiguous letter "?", midway between N and H, in N-biased lexical contexts (e.g., REIG?), plus words with unambiguous H (e.g., WEIGH); others saw the reverse (e.g., WEIG?, REIGN). The first group categorized more of the test continuum as N than did the second group. Control groups, who saw "?" in nonword contexts (e.g., SMIG?), plus either of the unambiguous word sets (e.g., WEIGH or REIGN), showed no such subsequent effects. Perceptual learning about ambiguous letters therefore appears to be based on lexical knowledge, just as in an analogous speech experiment (Norris, McQueen, & Cutler, 2003) which showed similar lexical influence in learning about ambiguous phonemes. We argue that lexically guided learning is an efficient general strategy available for exploitation by different specific perceptual tasks.     

The swimsuit issue: Correlates of body image in a sample of 52,677 heterosexual adults

Past research on adults’ body image has typically used small convenience samples, limiting the ability to examine associations of personal characteristics to body satisfaction. This study of 52,677 heterosexual adults ages 18–65 examined associations of body satisfaction to age, height, gender, and body mass index (BMI). Age and height were mostly unrelated to body satisfaction. Consistent with an Objectification Theory perspective, fewer men than women reported being too heavy (41% versus 61%), rated their body as unattractive (11% versus 21%), or avoided wearing a swimsuit in public (16% versus 31%). Men felt better about their bodies than women across most of the weight span, although among underweight individuals, women felt better than men. Slender women (BMIs 14.5–22.49) were more satisfied than most other women (BMIs 22.5–40.5). Among men, underweight and obese men were least satisfied. These findings highlight gender differences in the association of weight to body satisfaction.     

A covariance structure analysis of employees' response to performance feedback

This longitudinal study used D. R. Ilgen, C. D. Fisher, and M. S. Taylor's (1979) feedback process model as a theoretical framework to determine whether a sequential chain of cognitive variables mediates an individual's response to performance feedback. One hundred two employees were surveyed 2 weeks after their performance appraisal, and performance was assessed 11 months later at the end of the review cycle. Covariance structure analysis supported the convergent and discriminant validity of the constructs underlying the model and the constellation of structural relationships. A set of cognitive variables was found to completely mediate the relationship between an individual's receipt and response to feedback. Implications for the feedback process and future research are discussed.     

Writing About Upsetting Family Events: A Therapy Analog Study

This therapy analog study investigated whether a writing intervention based on contextual therapy would have positive effects on physical, mental, and relational health. One-hundred-and-three college students were randomly assigned to write about either an upsetting family event/issue from childhood or a trivial event during a four-day period. As anticipated, relative to the control participants, those in the experimental condition reported an increase in negative mood and physical symptoms immediately after writing each day. Also as anticipated, the experimental participants also reported feeling better about themselves and their topics at post-test. Unexpectedly, there were either no significant differences or differences in the unpredicted direction between the control and experimental groups in physical, psychological, and relational functioning at posttest and follow-up. However, post-hoc analyses revealed differential changes within the experimental group as a function of the personal relevance and the degree of previous disclosure of the topics. Limitations of written expression as a therapeutic tool are discussed.     

Do we know how we cope? Relating daily coping reports to global and time-limited retrospective assessments

The current study examined the concordance among daily, trait (global retrospective), and time-limited retrospective reports of coping. A sample of 93 adults completed the COPE (C. S. Carver, M. F. Scheier, & J. K. Weintraub, 1989) prior to recording coping with the day's most negative event for 30 consecutive days. At the end of daily data collection, participants recalled to what extent they used each of 16 coping strategies over the past 30 days. Whereas findings indicate generally good concordance between daily and time-limited retrospective reports, concordance between global and daily reports was weak. Only limited evidence was found for systematic individual differences in concordance. Time-limited reports appear to be an adequate, though not ideal, method of determining usual patterns of coping with stress.     

Traits and stories: links between dispositional and narrative features of personality

Dispositional traits and life narratives represent two different levels of personality that have not previously been empirically linked. The current study tested five hypotheses connecting Big-Five traits to life-narrative indices of emotional tone, theme, and structure. Students (Study 1) and adults (Study 2) completed a self-report measure of the Big-Five traits and provided extended written accounts of either ten (students) or eight (adults) key life-narrative scenes, including life high points, low points, and turning points. Content analysis of the narrative data revealed that for both samples Neuroticism was positively associated with an emotionally negative life-narrative tone, Agreeableness was correlated with narrative themes of communion (e.g., friendship, caring for others), and Openness was strongly associated with the structural complexity of life narrative accounts. Contrary to prediction, however, Conscientiousness was not consistently associated with themes of agency (e.g., achievement, self-mastery) and Extraversion was unrelated to positive narrative tone. The results are discussed in the context of contemporary research and theorizing on the narrative study of lives and the relation of narrative research in personality to more conventional, trait-based approaches.