Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction.

OBJECTIVE: To compare the impact of network support and different types of perceived functional support on all-cause mortality or nonfatal reinfarction for patients with a recent acute myocardial infarction (AMI). DESIGN: Participants were recruited from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) trial; 2,481 AMI patients with depression or low social support were randomized to a cognitive-behavioral intervention or to a usual care control group. Data collection for certain measures of social support was limited: 2,466 participants completed the ENRICHD Social Support Inventory; 2,457 completed the Perceived Social Support Scale; 1,296 completed the Social Network Questionnaire; and 707 completed the Interpersonal Support and Evaluation List, Tangible Support subscale. Patients also completed the Beck Depression Inventory and were followed for up to 4.5 years. MAIN OUTCOME MEASURE: Time to death or nonfatal reinfarction. RESULTS: Over the follow-up period, 599 patients (24%) died or had a nonfatal AMI. Survival models controlling age, sex, race, socioeconomic status, smoking, antidepressant use, and a composite measure of increased risk revealed that higher levels of perceived social support were associated with improved outcome for patients without elevated depression but not for patients with high levels of depression. Neither perceived tangible support nor network support were associated with more frequent adverse events. CONCLUSION: AMI patients should be assessed for multiple dimensions of perceived functional support and depression to identify those at increased psychosocial risk who may benefit from treatment.     

Understanding the relationship between obesity and positive and negative affect: the role of psychosocial mechanisms

We examined the relationship between body mass index (BMI) and positive and negative affect, and evaluated whether this relationship is mediated (or suppressed) by physical health, intrusiveness of weight on physical functioning, and distressing interpersonal interactions. Analyses were based on a national sample of more than 3,000 adults ages 25 to 74. Class II (BMI 35–39.9) and Class III (BMI ≥ 40) obesity were associated with more frequent negative affect and less frequent positive affect, even after demographic and socioeconomic status characteristics were controlled. After the purported pathway variables were controlled, however, obese I persons reported significantly more frequent positive affect, while overweight, obese I, and obese II persons reported significantly less frequent negative affect, compared to normal weight persons. These patterns did not differ significantly by race or gender. Our findings suggest that excessive body weight is not necessarily distressing, yet the physical and interpersonal strains associated with obesity may impair one's mood. We discuss the implications for policy and practice.     

Legal and Policy Responses to Children Exposed to Domestic Violence: The Need to Evaluate Intended and Unintended Consequences

Greater training and specialization in working with children exposed to domestic violence has resulted in new policies, interagency protocols, and legislation in many states. This paper examines court-related responses in criminal, child protection, and family court custody proceedings, which highlight legislative changes and resulting systemic change. Although this legislation originated with the best of intentions to assist and protect children, some of the most striking outcomes have been negative and unintended. Laws that mandate reporting of children exposed to domestic violence can clash with inadequate training and resources, or inadvertently revictimize abused women. Similarly, child custody legislation that raises a rebuttable presumption that a violent spouse will not receive custody or joint custody of children after parental separation has resulted in greater skepticism about abuse allegations. We propose that efforts at law reform can be enhanced by a more thoughtful analysis of potential intended and unintended consequences, and should be accompanied by a comprehensive evaluation plan to monitor implementation effects.     

The Effects of Children's Exposure to Domestic Violence: A Meta-Analysis and Critique

A wide range of children's developmental outcomes are compromised by exposure to domestic violence, including social, emotional, behavioral, cognitive, and general health functioning. However, there are relatively few empirical studies with adequate control of confounding variables and a sound theoretical basis. We identified 41 studies that provided relevant and adequate data for inclusion in a meta-analysis. Forty of these studies indicated that children's exposure to domestic violence was related to emotional and behavioral problems, translating to a small overall effect (Z _r = .28). Age, sex, and type of outcome were not significant moderators, most likely due to considerable heterogeneity within each of these groups. Co-occurrence of child abuse increased the level of emotional and behavioral problems above and beyond exposure alone, based on 4 available studies. Future research needs are identified, including the need for large-scale longitudinal data and theoretically guided approaches that take into account relevant contextual factors.     

Blending Arendtian Exemplarity with Weberian Ideal-Typic Analysis: Arendt’s ‘Socrates’ as a Vehicle for Social Critique

Arendt uses the exemplary validity of Socrates to think and value the possibilities of joint philosophical and political orientations in our present juncture. In this way Arendt’s ‘Socrates’ is not a mythic, historic, or dramatic individual, but offers an example of the best of the human condition. Unfortunately, because Arendt held the social conditioning and constraining of Socrates’ possibilities at arm’s length, his status as an exemplar is problematic and he ends up referring to a historical rather than contemporary possibilities. While Arendt had resources in her notion of the ‘world’ to better ground her simultaneously analytic and normative construction of ‘Socrates’, the lack of a social grounding makes ‘Socrates’ a significantly unmoored and shifting signifier. After showing the vacillations of ‘Socrates’ in Arendt, I supplement her normatively laden account with a Weberian grounding. With this firmer social grounding, ‘Socrates’ can refer to the possibilities of joint philosophical and political orientations in ancient Athens and thereby highlight how our world makes a contemporary version unlikely or impossible. Yet, this Weberian grounding comes at a cost. The normative dimension essential in Arendt’s ‘Socrates’ is lost due to Weberian value-neutrality. ‘Socrates’ can name a contemporary unlikelihood or impossibility, but if the enveloping social order does not value what it renders impossible, Weberian ideal-types on their own are incapable of offering normative resources for critique. I conclude by blending a Weberian social mooring with Arendt’s value-laden framework for social analysis and thereby recuperate the missing normative dimension. In short, by accepting the relational, necessarily plural, and dynamic root of human action we can, much like Arendt’s intended use of ‘Socrates’, value orientations that best express these norms, and criticize contemporary conditions that constrain their realization.     

Books

On polarity: Wilfred sheed's max jamisen eudora warn's losing battles