Young Indigenous Australians' Sexually Transmitted Infection Prevention Practices: A Community‐based Participatory Research Project

National surveillance data indicate marked differences between Indigenous and other Australians in the prevalence of many sexually transmitted infections (STIs). Young Indigenous people bear a particularly high burden of these infections. A collaboration of university researchers, Indigenous health workers and young Indigenous people conducted 45 field interviews to examine how young Indigenous Australians keep themselves healthy and protected against STIs. Our findings emphasise the complexity of health behaviours, where individuals are rarely always ‘risky’ or always ‘safe’, as well as subtle gender differences in health practices. Preventive strategies employed by the young people were contingent on beliefs and knowledge about sexual partners, the type of relationship, the context of the sexual encounter and access to condoms. Tangible strengths such as young Indigenous people's commitments to condoms and STI screening should be celebrated and bolstered to enhance their ability to protect themselves against adverse health outcomes and enhance their resilience against STIs. Focusing on strengths helps to counter the deficit model of health commonly deployed in Indigenous health research and draws attention to health issues facing young Indigenous people and their communities, without reinforcing negative stereotypes or focusing solely on individual risk behaviour. We provide concrete recommendations for health promotion and education. Copyright © 2011 John Wiley & Sons, Ltd.     

Physician Burnout and Patient Satisfaction with Consultation in Primary Health Care Settings: Evidence of Relationships from a one-with-many Design

Physician burnout, as a prolonged response to chronic emotional and interpersonal stressors on the job, has been associated with suboptimal patient care and deterioration in the patient?Cprovider relationship. Although prior studies have identified a range of factors associated with decreased patient satisfaction, most have been conducted in tertiary care settings, with staff burnout examined at the hospital unit-level. To examine the impact of physician burnout on patient satisfaction from consultation in the primary care setting, a cross-sectional survey was conducted in Western Greece. Using a one-with-many design, 30 physicians and 300 of their patients, randomly selected, responded to the survey. Results showed that patient satisfaction correlated significantly with physician emotional exhaustion (r = ?.636, p < .01) and physician depersonalization (r = ?.541, p < .01). Mixed-effects multilevel models indicated that 34.4% of total variation in patients?? satisfaction occurred at the physician level, after adjustment for patients?? characteristics. Moreover, physician emotional exhaustion and depersonalization remained significant factors associated with patient satisfaction with consultation, after controlling for patient and physician characteristics. Patients of physicians with high-exhaustion and high-depersonalization had significantly lower satisfaction scores, compared with patients of physicians with low-exhaustion and low-depersonalization, respectively. Future studies need to explore the mechanisms by which physician burnout affects patient satisfaction.     

Addressing Challenges in Individual Psychotherapy with Delusional Patients: A Case Study

Although cognitive-behavioral treatments for schizophrenia and other psychotic disorders demonstrate strong results in clinical trials, not all patients respond to these treatments. Common challenges in psychotherapy with delusional patients include a mismatch between the therapist’s and the patient’s expectations about the purpose of therapy, the patient’s lack of motivation to reduce delusional beliefs in service of other goals, and the patient’s dependence on the delusions in order to preserve an intact sense of self. This case highlights the value of integrating a psychodynamic perspective with cognitive-behavioral interventions to address challenges in psychotherapy with chronically delusional patients.     

A test of the circumvention-of-limits hypothesis in scientific problem solving: the case of geological bedrock mapping

Sources of individual differences in scientific problem solving were investigated. Participants representing a wide range of experience in geology completed tests of visuospatial ability and geological knowledge, and performed a geological bedrock mapping task, in which they attempted to infer the geological structure of an area in the Tobacco Root Mountains of Montana. A Visuospatial Ability × Geological Knowledge interaction was found, such that visuospatial ability positively predicted mapping performance at low, but not high, levels of geological knowledge. This finding suggests that high levels of domain knowledge may sometimes enable circumvention of performance limitations associated with cognitive abilities.     

Is Low Anxiety Part of the Psychopathy Construct?

Low anxiety has traditionally been considered a feature of psychopathy, but there has been mixed research support for this conceptualization. We investigated the PPI-R-SF Stress Immunity subscale (a measure of low anxiety) in relation to 2 widely used self-report psychopathy scales in a sample of 346 undergraduate students. Results indicated that PPI-R-SF Stress Immunity was nearly unrelated to other indicators of psychopathy, showing a near-zero loading on the common psychopathy factor defined jointly by the scales of the PPI-R-SF and SRP-III. Stress Immunity also showed a pattern of personality and temperament correlates much different from those of other psychopathy subscales. Finally, Stress Immunity had a slight negative correlation with self-reports of diverse antisocial acts. These results suggest that despite its historical importance in the conceptualization of psychopathy, low anxiety is likely not a core feature of psychopathy.     

The Relations among Maternal Depressive Disorder, Maternal Expressed Emotion, and Toddler Behavior Problems and Attachment

Direct and indirect relations among maternal depression, maternal Expressed Emotion (EE: Self- and Child-Criticism), child internalizing and externalizing symptoms, and child attachment were examined. Participants were mothers with depression (n?=?130) and comparison mothers (n?=?68) and their toddlers (M age?=?20 mo.; 53% male). Assessments included the Diagnostic Interview Schedule (maternal depression); the Five Minute Speech Sample (EE); the Child Behavior Checklist (toddler behavior problems); the Strange Situation (child attachment). Direct relations were significant linking: 1) maternal depression with both EE and child functioning; 2) Child-Criticism with child internalizing and externalizing symptoms; 3) Self-Criticism with child attachment. Significant indirect relations were found linking maternal depression with: 1) child externalizing behaviors via Child-Criticism; 2) child internalizing behaviors via Self- and Child-Criticism; and 3) child attachment via Self-Criticism. Findings are consistent with a conceptual model in which maternal EE mediates relations between maternal depression and toddler socio-emotional functioning.     

Nonword repetition and phoneme elision in adults who do and do not stutter

The purpose of the present study was to explore the phonological working memory of adults who stutter through the use of a non-word repetition and a phoneme elision task. Participants were 14 adults who stutter (M=28 years) and 14 age/gender matched adults who do not stutter (M=28 years). For the non-word repetition task, the participants had to repeat a set of 12 non-words across four syllable lengths (2-, 3-, 4-, and 7-syllables) (N=48 total non-words). For the phoneme elision task, the participants repeated the same set of non-words at each syllable length, but with a designated target phoneme eliminated. Adults who stutter were significantly less accurate than adults who do not stutter in their initial attempts to produce the longest non-words (i.e., 7-syllable). Adults who stutter also required a significantly higher mean number of attempts to accurately produce 7-syllable non-words than adults who do not stutter. For the phoneme elision task, both groups demonstrated a significant reduction in accuracy as the non-words increased in length; however, there was no significant interaction between group and syllable length. Thus, although there appear to be advancements in the phonological working memory for adults who stutter relative to children who stutter, preliminary data from the present study suggest that the advancements may not be comparable to those demonstrated by adults who do not stutter. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to (a) summarize the nonword repetition data that have been published thus far with children and adults who stutter; (b) describe the subvocal rehearsal system, an aspect of the phonological working memory that is critical to nonword repetition accuracy; (c) employ an alternative means to explore the phonological working memory in adults who stutter, the phoneme elision task; and (d) discuss both phonological and motoric implications of deficits in the phonological working memory.     

Compliance,opposition, and behavior problems in toddlers born preterm or low birthweight

Although children born preterm or low birth weight (PT LBW) are more likely to exhibit behavior problems compared to children born at term, developmental and family processes associated with these problems are unclear. We examined trajectories of maternal depressive symptoms in relation to toddler compliance and behavior problems in families with PT LBW infants. A total of 177 infants (93 boys, 84 girls) and their mothers enrolled in the study during the infant's NICU stay. Data were collected at five time points across 2 years. Assessments of maternal depressive symptoms were conducted at all time points, and toddler compliance and opposition to maternal requests and behavior problems were assessed at 2 years. Toddlers born earlier with more health problems to mothers whose depressive symptoms increased over time exhibited the most opposition to maternal requests during a cleanup task at 24 months, consistent with multiple risk models. Mothers with elevated depression symptoms reported more behavior problems in their toddlers. The study has implications for family‐based early intervention programs seeking to identify PT LBW infants at highest risk for problem behaviors.