Effect of valued activity disability, social comparisons, and satisfaction with ability on depressive symptoms in rheumatoid arthritis.

This longitudinal study identified a model through which function affects the psychologicalwell-being of individuals with rheumatoid arthritis (RA). Results of hierarchical linear regression analyses (N = 436) demonstrated that greater physical impairment resulted in greater disability in valued activities and engagement in unfavorable social comparisons. All 3 factors--greater physical impairment, greater disability in valued activities, and unfavorable comparison evaluations--predicted low satisfaction with abilities. Low satisfaction with abilities was the most important predictor of higher depressive symptoms and mediated the impact of physical impairment, valued activity disability, and unfavorable comparisons on depressive symptoms. Results highlight the role of personal meaning attached to changes in functional status in predicting the long-term psychological well-being of individuals with chronic illnesses such as RA.     

Some Common Characteristics of Latency-Age Suicidal Children: A Tentative Model Based on Case Study Analyses

ABSTRACT: Eleven latency-age (6 ½ to 12 ½) boys and girls who attempted or threatened suicide were investigated by means of the following information: intensive interviews, therapeutic meetings, direct observation in school, meetings with teachers, and survey of school records. The families of the children were also interviewed. In spite of the many differences between the children's personalities and backgrounds, some common dynamic features seemed to emerge: (a) There was a suicidal parent in the family, in most cases the mother; (b) Most of the families of these children were engaged in a major crisis, not necessarily centered around the suicidal child; (c) The children experienced demands by the parents to assume responsibilities which the children perceived as being beyond their capability; (d) There was a lack of satisfying relationships with adults; (e) Most children perceived death in a paradoxical way, believing that death was a need satisfying state yet fearing death; (f) The children showed strong positive strivings to say alive and were able to experience joy and happiness in spite of feelings of desperation and depression. A model based on the above multifaceted forces is presented. These forces consist of attractiveness of life, repulsiveness of life, attractiveness of death, and repulsiveness of death. Some of diagnostic and predictive uses of this model are elaborated.