Compromising health

The Health Services Since the War, Vol. 1, Problems of Health Care: The National Health Service Before 1957, by Charles Webster, HMSO, 1988, 479 pages, hb £27.50.     

"If we work hard,we can do it" a tale from an olympic (gold) medallist

The purpose of this study was to gain day-to-day insight into how an elite athlete experiences competing in the Olympic Games with regard to perceived stress, the subsequent coping efforts, and the maintenance of a positive response outcome expectancy. One Norwegian female soccer player wrote a journal throughout the pre-camp and the 2000 Olympic Games in Sydney. "Tina" employed a range of coping strategies, both problem-focused and emotion focused, when faced with challenges such as feeling a lack of self-confidence and the team losing the first match. However, she kept a strong belief in her team's ability to win and had a strong positive response outcome expectancy throughout the targeted period. The team won the Olympic Gold medal and Tina attributed this achievement to the hard work everybody on the team had exhibited over a long period of time. The results of this qualitative analysis are discussed with respect to contemporary theories of stress, coping, and motivation.     

No Moral Absolutes

In search of a potential problem with cloning, I investigate the phenomenon of telomere shortening which is caused by cell replication; clones created from somatic cells will have shortened telomeres and therefore reach a state of senescence more rapidly. While genetic intervention might fix this problem at some point in the future, I ask whether, absent technological advances, this biological phenomenon undermines the moral permissibility of cloning.     

Structural-functional correlations between hippocampal volume and cortico-limbic emotional responses in depressed children

Although hippocampal atrophy and altered functional brain responses to emotional stimuli have been found in major depressive disorder (MDD), the relationship between the two is not yet well understood. The present study focused on children with and without a history of preschool onset MDD (PO-MDD) and directly examined the relations between hippocampal volume and functional brain activation to affect-eliciting stimuli. Children completed annual diagnostic assessments starting at preschool. When children were school-aged, high-resolution structural MRI and task-related functional MRI data were acquired from N = 64 nonmedicated children. During fMRI, subjects were shown emotional faces. Results from the total sample indicated that smaller bilateral hippocampal volumes were associated with greater cortico-limbic (e.g., amygdala, hippocampus, dorsolateral prefrontal cortex) activation to sad or negative faces versus neutral faces. Left hippocampal volume was negatively associated with the cortico-limbic activation in both the PO-MDD and healthy children. Right hippocampal volume was negatively correlated with amygdala responses in the PO-MDD group, but not in the healthy comparison group. These findings suggest that there may be important interrelationships between reduced hippocampal volume and hyperactivation of brain responses in children, both those with and those without a history of PO-MDD.     

The stability of structural measures derived from repertory grids

Although the use of repertory grids in psychological research has proliferated, studies of their psychometric properties are relatively rare. For this reason, we studied the reliability and convergence of several measures of cognitive structure derived from grids, including intensity, percentage of variance accounted for by the first component, cognitive complexity, ordination, extremity of ratings, self-ideal discrepancy, and self-other discrepancy, as well two measures of rating stability, construct consistency and factor loading consistency. Eighty-two Spanish (Catalan) and American participants completed small and large grids on each of four occasions, which enabled exploratory analyses of the impact of grid size and subject characteristics on the structural scores obtained. Results indicated that the majority of scores showed impressive test-relest reliability (modal r = .85 for periods up to 1 month), but also suggested a gradual tightening effect across subsequent administrations. In general, scores intercorrelated in theoretically anticipated ways, converging on the assessment of cognitive differentiation and discrimination of elements within construct dimensions. The results have implications for the reactivity of structural scores to variations in grid format, as well as for use of grids in the study of sex differences and cross-cultural comparisons.     

Post-Traumatic Stress Disorder Nightmares and Sleep Disturbance in Iraq War Veterans: A Feasible and Promising Treatment Combination

A substantial proportion of returnees from the Iraq war have significant psychological symptoms related to war zone exposure, including high rates of post-traumatic stress disorder (PTSD), nightmares, and sleep disturbances. This pilot investigation examined the feasibility and efficacy of a promising cognitive-behavioral treatment (CBT) for nightmares, Imagery Rehearsal, combined with CBT for insomnia. Seven veterans completed treatment and showed promising pre-post effects regarding nightmare frequency, sleep quality, and PTSD. This report further examined the content of participants' nightmares, changes made during treatment, and potentially important modifying variables of treatment outcome. Those with redeployment fears, guilt due to perpetration issues, or traumatic brain injuries may receive some but not full benefits of the treatment.     

Child Maltreatment,Emotion Regulation,and Posttraumatic Stress: The Impact of Emotional Abuse

This study examined the relationship of emotion regulation to multiple forms of child abuse and subsequent posttraumatic stress. Particular consideration was given to emotional abuse, which has received less attention in the literature. Results from a survey of 912 female college students revealed that women who reported a history of sexual, physical, or emotional abuse endorsed greater emotion regulation difficulties compared to women without abuse histories. Notably, emotional abuse was the strongest predictor of emotion deregulation. Mediation analyses indicated that emotion dysregulation partially explained the relationship between physical and emotional abuse and symptoms of posttraumatic stress, suggesting that intervention efforts aimed at improving emotion regulation strategies might be beneficial in decreasing posttraumatic stress among women with child maltreatment histories.     

Childhood Domestic Violence Exposure among a Community Sample of Adult Perpetrators: What Mediates the Connection?

The association between childhood exposure to domestic violence and later intimate partner violence (IPV) perpetration in adulthood has been well established in the literature. However, the literature examining the factors of exposure that contribute to perpetration in adulthood is fraught with mixed findings, with some studies finding a direct link between childhood domestic violence exposure and later IPV perpetration and others ruling out a link after controlling for other contextual barriers such as community violence and socioeconomic status. This study examined 124 non-treatment-seeking and unadjudicated adult male IPV perpetrators and found exposure to domestic violence in childhood contributes to the normalization of violence, which could predict future adult IPV perpetration. Practice implications are discussed, namely primary and secondary prevention of intimate partner violence.     

Attachment Style and Early Maladaptive Schemas as Mediators of the Relationship between Childhood Emotional Abuse and Intimate Partner Violence

Theoretical and empirical research suggests possible pathways between women's experiences of childhood emotional abuse (CEA) and later intimate partner violence victimization (IPV-V) and perpetration (IPV-P), including attachment style and early maladaptive schemas. This study tested a model examining the unique mediating effects of insecure attachment and early maladaptive schemas on the relationship between CEA and IPV-V (n?=?396) or IPV-P (n?=?409) in college women. Contrary to hypotheses that both attachment style and maladaptive schema endorsement would mediate the relationship between CEA and IPV-V and IPV-P, regression analyses indicated the disconnection/rejection schema domain was the only significant mediator between CEA and IPV-V (p = .01). This same relation held for childhood emotional abuse and IPV-P (p < .001). These findings provide preliminary clinical utility for examining schema endorsement, the use of schema therapy (Young, Klosko, &; Weishar, 2003 Young, J. E., Klosko, J. S. and Weishar, M. E. 2003. Schema therapy: A practitioner's guide, New York: NY: Guilford.  [Google Scholar]), or both with women who have emotional abuse and IPV histories.