The Role of Beliefs in the Relationship Between Health Problems and Posttraumatic Stress in Adolescent and Young Adult Cancer Survivors

In addition to the potential for ongoing health concerns, adolescent and young adult (AYA) childhood cancer survivors frequently report posttraumatic stress symptoms (PTSS). The current study examines whether beliefs about health moderate the relationship between the number of health problems and PTSS 2 months later in 140 survivors. Beliefs, as measured by scales of the Health Competence Beliefs Inventory (HCBI), negatively related to PTSS while health problems positively related to PTSS. Three scales of the HCBI-health perceptions, satisfaction with healthcare and cognitive competence—were significant moderators. The relationship between health problems and PTSS was stronger in the presence of less adaptive beliefs. These beliefs represent potentially malleable intervention targets for reducing PTSS in childhood cancer survivors.     

Clinical issues in analyses over the telephone and the internet

There is professional consensus that teleanalysis, the practice of psychoanalysis conducted remotely using the telephone and the Internet, is increasing in response to more mobility in the population. But there is controversy as to whether the use of technology leads to a dilution of analysis or to adaptive innovation that is clinically effective and true to the tenets of psychoanalysis. The author reviews the psychoanalytic literature and shows the development of analytic thinking about this technology-assisted practice of psychoanalysis. She summarizes analysts' perceptions and experiences of the advantages and disadvantages, and considers the indications and contra-indications. She focuses on the clinical concerns that arise in terms of the frame, resistance, and the development of analytic process through the unconscious communication of internal objects, unconscious fantasy, transference and countertransference. She gives vignettes from the analysis of a man with trauma-related depression to address the concerns raised and to support her argument that analysis using the telephone and the Internet is a viable, clinically effective alternative to traditional analysis where necessary.     

The Unseen Cost: A Discussion of the Secondary Traumatization Experience of the Clergy

The vocation of clergy life can be a hazardous journey. Stress and burnout are issues, which are increasingly reported by clerics. Burnout is defined by a constellation of work related symptoms (Doolittle, Mental Health, Religion & Culture,10(1), 31–38, 2007), with emotional exhaustion recognised as a core component. Despite this recognition the research has not focused on factors which lead to this state of emotional exhaustion in particular secondary traumatization. The purpose of this article is threefold. Firstly, it presents the theoretical framework of secondary trauma. Secondly it reviews the literature aligning clergy and trauma work and thirdly it discuses the emotional and physical toll upon clergy from this aspect of their role.     

Spirituality in Older Adulthood: Existential Meaning,Productivity, and Life Events

The purpose of this article is to explore the relationship of spirituality and older adulthood, especially focusing on factors that may result in an increased spirituality among the elderly. Older adulthood, as the accumulation of insight gleaned from difficult lessons learned through life, offers the opportunity to embrace human finitude, to recognize life’s continuity and to grow in clarity about God and God’s presence. Wisdom gained through the experiences of vulnerability and transition serves as a resource to self and others. This article draws on the reflections of William M. Clements, Ph.D., Edna and Lowell Craig Professor of Pastoral Care and Counseling at the Claremont School of Theology.     

The effect of Obama saliency on individual-level racial bias: Silver bullet or smokescreen?

President Obama's election has been construed as a potentially positive force for intergroup relations, but this issue has not been previously addressed experimentally. In experiment 1, conducted 4-5 months after the election, White participants were primed with either President Obama or nature before completing a variety of race-related measures. Results indicated that priming Obama did not influence implicit racial bias or internal motivation to control prejudice. However, consistent with exemplar and symbolic racism theories, participants primed with President Obama expressed greater agreement with the tenets of symbolic racism and were more reluctant to accept the possibility that they personally harbored subtle racial bias. Experiment 2, conducted 21 months after the election, replicated the Obama effects from experiment 1 and showed that priming another Black exemplar (Oprah) also increased symbolic racism. Results suggest that highly successful Black exemplars currently serve as a smokescreen for symbolic and subtle racial biases.     

Getting precise and pragmatic about the assessment of bullying: the development of the California Bullying Victimization Scale

Accurate assessment of bullying is essential to intervention planning and evaluation. Limitations to many currently available self-report measures of bullying victimization include a lack of psychometric information, use of the emotionally laden term "bullying" in definition-first approaches to self-report surveys, and not assessing all components of the definition of bullying (chronicity, intentionality, and imbalance of power) in behavioral-based self-report methods. To address these limitations, we developed the California Bullying Victimization Scale (CBVS), which is a self-report scale that measures the three-part definition of bullying without the use of the term bully. We examined test-retest reliability and the concurrent and predictive validity of the CBVS across students in Grades 5-12 in four central California schools. Concurrent validity was assessed by comparing the CBVS with a common, definition-based bullying victimization measure. Predictive validity was examined through the co-administration of measures of psychological well-being. Analysis by grade and gender are included. Results support the test-retest reliability of the CBVS over a 2-week period. The CBVS was significantly, positively correlated with another bullying assessment and was related in expected directions to measures of well-being. Implications for differentiating peer victimization and bullying victimization via self-report measures are discussed.     

From Demonization of the Masses to Democratic Practice in the Work of Nietzsche,Heidegger, and Foucault

This paper argues that the dichotomy between individuals, as bearers of unique and freely chosen identities, and the masses, as the large numbers of others who are conforming and uncritical, should be understood as a constructed dichotomy. This dichotomy is both supported and dismantled in the works of Friedrich Nietzsche, Martin Heidegger, and Michel Foucault. Each of these thinkers reinforced the idea that there exist conforming and threatening masses from which individuals should separate themselves. And yet by theorizing the limitations and contextual nature of individual identity, they have also provided the foundations for revealing the dichotomy as illusory as well as problematic for reasoned thought and politics. The significance of this argument is that the fear of sameness and conformity within modern mass society creates a serious obstacle to broad based and democratic political engagement among people.     

Re-Visioning Medicine

Studies suggest that medical students and physicians have higher rates of anxiety, depression, and suicidal ideation than their peers in the general population. Some authors have suggested that medical culture perpetuates these problems by erecting “barriers to treatment,” preventing students and physicians from getting the help they need. Here, the author begins a broader examination of the potential role of culture by examining the myths and symbols that form the basis for medical culture and the medical self-image. The author argues that a medical self-image based on a de-contextualized medical mythology, the Asclepius myth, results in a sense of professional identity that is unbalanced, dehumanized, and characterized by unattainable expectations. The outward expression of this medical self-image, the medical culture, is often a-relational, unhealthy, stressed, or even toxic. The author suggests some ways of re-modeling medical culture, including its rituals and symbols, and medical education in ways that incorporate what is currently kept in its shadow.     

Group critical incident stress debriefing with emergency services personnel: a randomized controlled trial

Although single-session individual debriefing is contraindicated, the efficacy of group psychological debriefing remains unresolved. We conducted the first randomized controlled trial of critical incident stress debriefing (CISD) with emergency workers (67 volunteer fire-fighters) following shared exposure to an occupational potentially traumatic event (PTE). The goals of group CISD are to prevent post-traumatic stress and promote return to normal functioning following a PTE. To assess both goals we measured four outcomes, before and after the intervention: post-traumatic stress, psychological distress, quality of life, and alcohol use. Fire brigades were randomly assigned to one of three treatment conditions: (1) CISD, (2) Screening (i.e., no-treatment), or (3) stress management Education. Controlling for pre-intervention scores, CISD was associated with significantly less alcohol use post-intervention relative to Screening, and significantly greater post-intervention quality of life relative to Education. There were no significant effects on post-traumatic stress or psychological distress. Overall, CISD may benefit broader functioning following exposure to work-related PTEs. Future research should focus on individual, group, and organizational factors and processes that can promote recovery from operational stressors. Ultimately, an occupational health (rather than victim-based) approach will provide the best framework for understanding and combating potential threats to the health and well-being of workers at high risk for PTE exposure.