A Review of: “Fairburn,C. G. (2008). Cognitive Behavior Therapy and Eating Disorders.”

Successful reports of behavioral treatment of encopresis describe interventions as unpleasant as the disorder: hospitalization, laxatives, prompted toileting, aversive consequences. The focus on soiling rather than on the constant constipation that precedes encopresis, on the reduction of soiling rather than on the acquisition of effective toilet use. Five normal chronically constipated children (four of whom were encopretic) were treated at home with combinations of: preparatory instructions, rewards for clean pants, reward for appropriate toileting (bowel movement in toilet). Once soiling was eliminated and appropriate bowel movements occured regularly, all families were taught to fade treatment contingencies. To determine the contribution of the toileting reward to treatment effectiveness, this reward was added to the other two treatment components in a multiple baseline across four cases; it provided a significant ingredient in short-term success. A fifth child achieved short-term success with only the instructions and the clean pants reward. Long-term results (11-20 months) revealed that the fifth child, who never received the toileting reward, was the only one who relapsed.     

The impact of national integration policies on prejudice and psychological well-being: The fundamental role of the clarity and coherence of integration policies

Recent advances in social psychological research have shown that national integration policies influence how immigrants are perceived and treated by the mainstream population. However, the processes by which these policies come to have an impact on prejudice and well-being of the general population are largely unknown. Moreover, past research has often relied on unrepresentative samples limiting generalizability. The present research proposes that when the national integration policies of a given society are perceived as clearly defined and coherent, they have a direct impact on the perceived cultural norm related to those national integration policies. In turn, the perceived cultural norm affects personal attitudes toward cultural norms (i.e., the degree to which individuals support a given policy), which influence the level of anti-immigrant prejudice as well as psychological well-being. Findings from two correlational studies with representative samples of the mainstream population conducted in France on the policy of secularism (N = 940) and in Québec on the policy of interculturalism (N = 912) supported the proposed theoretical model.     

An Assessment of Genetic Counseling Services for Individuals with Multiple Sclerosis

Multiple sclerosis (MS) affects up to 1/500 Canadians. The University of British Columbia MS Clinic (UBC Clinic) is the only MS clinic in Canada (and likely internationally) that routinely offers genetic counseling to patients and their families. A typical session includes the collection of family history and demographic data, discussion of the inheritance of MS, interpretation of family-specific recurrence risks and psychosocial counseling. The aims of this study were to explore patients’: 1) expectations of the genetic counseling session; 2) understanding of the etiology of MS (both pre and post-session); and 3) post-session perceptions of genetic counseling. A two-part questionnaire to assess genetic counseling services was distributed before and after sessions to all consenting patients seen during the period October 1, 2008 to February 28, 2009 inclusive. Sixty-two completed questionnaires were analysed. Genetic counseling was found to significantly increase the number of individuals who were able to correctly identify the etiology of MS (p?<?0.001). Patient satisfaction with genetic counseling was high, with an average satisfaction score of 32.4/35 (92.6 %). Of those who provided comments (n?=?42/60) regarding the usefulness of the genetic counseling session, 95.2 % reported it useful (n?=?40/42). Findings suggest that genetic counseling is effective in increasing patients’ knowledge of the etiology of MS and is viewed by patients as a useful service. Based on the high level of positive feedback regarding genetic counseling by the study sample, this study suggests that the services provided by genetic counselors may be beneficial for patients with MS seen in other centers.     

Perceived acculturation preferences of minority groups and intergroup discrimination: When culture‐specific intergroup norms matter

The present research seeks to show that culture‐specific variables can moderate the impact of general determinants of intergroup discrimination, usually assumed to operate identically across cultures. The present paper reports the results of two studies testing the hypothesis that, in France, the cultural norm of new laïcité (a French‐specific ideology of secularism) can moderate the impact of the perceived host culture adoption and national identification on discrimination against immigrants. We conducted a correlational study (Study 1, N = 249) and an experiment (Study 2, N = 143) using two distinct and previously validated measures of intergroup discrimination. Results showed that the higher the perception of a norm of new laïcité, the stronger the link between host culture adoption and national identification. More specifically, among native French people, the perception of a weak host culture adoption and a weak national identification on the part of immigrants produced higher levels of discriminatory behavior especially when the intergroup norm of new laïcité was high. These studies highlight the fundamental importance of taking into account culture‐specific variables in the study of discrimination and point to the fact that, by changing the normative context, one may change intergroup behaviors. Reducing intergroup discrimination in applied settings may require targeting culture‐specific intergroup norms.     

大渐弥留的混沌之态：评《生死有时》一书

在人类命运共同体遭受一场前所未有的大疫威胁之际,上海教育出版社及时地推出了《生死有时》一书。尽管其副标题发问的要点是“美国医院如何型塑死亡”,但这个问题的尖锐性指向几乎是所有的重症医学实践。大疫将人之死的个体性纳入到一个疾病全球化的视野,《生死有时》并没有讨论重大公共卫生危机导致的世界性灾难,然而也能让我们联想到一个存在主义意义的危机问题。那就是大渐弥留的混沌之态。在此书中,涉及生命末端期的混沌问题包括：尊严死何以可能？旨在尊重患者主体性的生前预嘱是否可行？针对重症患者的医疗措施应该何时从常规治疗过渡到临终关怀？

     

Coparenting Profiles in the Context of Mexican‐Origin Teen Pregnancy: Links to Mother–Daughter Relationship Quality and Adjustment

The current study explored the multifaceted nature of the mother–adolescent coparental relationship with data from 167 Mexican‐origin adolescent mothers and their own mothers at 10 months post childbirth. Profiles of mother–adolescent coparenting were created with latent profile analysis using adolescents’ reports of three dimensions of coparenting (communication, involvement, and conflict). Four profiles were identified: (a) Harmonious Coparents (equal involvement, high communication, low conflict); (b) Harmonious‐Adolescent Primary (adolescent is more involved than mother, high communication, low conflict); (c) Conflictual Coparents (equal involvement, high communication, high conflict); and (d) Conflictual‐Adolescent Primary (adolescent is more involved than mother, moderate communication, high conflict). Families characterized by high mother–daughter conflict and psychological control prior to childbirth were more likely to belong in the Conflictual Coparents profile. In addition, adolescents’ and mothers’ depressive symptoms and parenting efficacy after childbirth were linked to profile membership, such that the Harmonious‐Adolescent Primary profile reported the most positive adjustment patterns, whereas profiles with high coparental conflict (i.e., Conflictual Coparenting and Conflictual‐Adolescent Primary profiles) showed the least positive adjustment patterns. Discussion considers the applied implications of identifying precursors to healthy and problematic mother–daughter coparenting for families of adolescent mothers in the early years of parenting.     

Accuracy of Reported Family History and Effectiveness of Medical Record Requests in Genetic Counseling for Alzheimer Disease

The University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders (UBCH-CARD) invests significant effort to obtain medical records for the confirmation of patient–reported family histories of dementia. The effectiveness of requesting these records was assessed through a review of the 275 requests made by UBCH-CARD genetic counselors during the 24-month period of January 1, 2005–December 31, 2006. The results were categorized according to outcome. Useful medical records were obtained from 92 (33.5%) requests: 77 (28%) records supported, and 15 (5.5%) records did not support, the patient–reported information. An additional 20 (7.5%) requests yielded only vague information. When verification was possible, patient–reported family histories of Alzheimer disease, dementia, or memory loss were accurate in 84% of cases. During the study period, almost 500 h of genetic counselor work time was spent obtaining, reviewing, and following-up on records received. Changes made to UBCH-CARD procedure in response to these findings are discussed.