Spiritual and emotional determinants of health

Within our present health care system, there is a growing movement that argues that our perceptions of health and illness are in need of change. This change includes redefining what we mean by health in terms of the whole person—the emotional, social, and spiritual dimensions of our being, as well as the physical. An increasing number of health professionals and social scientists believe our concepts of health and illness must consider all these aspects of life. It is believed that the quality of life may be enhanced by such perceptions of health, which include social and spiritual factors. Using data from the 1985 Akron Area Survey—The Subjective Quality of Life in the Akron Area—this study explores the effects of spiritual well-being and emotional well-being on health satisfaction. Results indicate that emotional and spiritual factors do significantly contribute to the subjective evaluation of health, especially for individuals who are physically limited.An earlier draft of this paper was presented at the joint session of the Association for the Sociology of Religion and the American Sociological Association, August 20, 1986. The author would like to thank Margaret Poloma, Ph.D., The University of Akron, and Mark Tausig, Ph.D., The University of Akron, for their helpful comments.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

A comparison of alternative theoretical approaches to smoking cessation and relapse

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.     

Orientation discrimination and cortical function in the human newborn

There is some controversy concerning whether or not the visual abilities of the newborn are mediated entirely through subcortical pathways or whether the visual cortex is functioning at birth. A critical test of cortical functioning is discrimination of orientation: orientation-selective neurons are found in the visual cortex but not in subcortical parts of the visual system. An experiment is described in which newborn infants were habituated to a square-wave grating oriented 45 degrees from vertical. After habituation, significant preferences for the novel, mirror-image, grating were found, a result which argues for some degree of visual cortical functioning at birth.     

Self-Reported Delinquency,neuropsychological deficit,and history of attention deficit disorder

This study was designed to evaluate the possibility that a pattern of cognitive deficit is associated with delinquent behavior, while avoiding some of the methodological problems of previous research. The Self- Report Early Delinquency instrument and a research battery of neuropsychological tests were administered blindly to an unselected cohort of 678 13- year- olds. Because the diagnosis of attention deficit disorder (ADD) was found at markedly elevated rates in the backgrounds of these delinquents, the possibility was examined that the neuropsychological deficits of delinquents might be limited to delinquents with histories of ADD. Although delinquents with past ADD were more cognitively impaired than non-ADD delinquents, both groups scored significantly below nondelinquents on verbal, visuospatial, and visualmotor integration skills. In addition, ADD delinquents scored poorly on memory abilities. Subjects with ADD who had not developed delinquent behavior were not as cognitively impaired as ADD delinquents, suggesting that it is the specific comorbidity of ADD and delinquency that bears neuropsychological study.This work was supported by USPHS Grant 1 R23 MH-42723-01 from the Antisocial and Violent Behavior Branch of the National Institute of Mental Health. The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Medical Research Council of New Zealand. Appreciation is expressed for the methodological advice of Prof. Sarnoff A. Mednick, and for the data collection efforts of Mrs. Pat Brasch, Mrs. Kathleen Campbell, Mr. Rich Poulton, and the psychometrists who administered the WISC-R.     

Attempted suicide in youth: Its relationship to school achievement,educational goals,and socioeconomic status

Twenty-six suicide attempters, 9 to 18 years of age, were compared with 725 nonattempters on measures of school achievement, educational goals, socioeconomic status, and depression. As has been found in studies using clinical samples, suicide attempters in our communitybased sample had significantly lower school achievement than nonattempters. The relationship between attempted suicide and low school achievement seemed to be explained by the effects of depression. Lower-SES youth tended to be more likely to attempt suicide than higher-SES youths. However, SES appeared to have little effect on the relationship between attempted suicide and school achievement. Results also suggest that children of mothers with low educational goals for them may be more at risk for attempted suicide than youths whose mothers have higher educational goals for their children.This research was supported by the National Institute of Mental Health, Grant No. MH36971.