Three views of organ procurement policy: moving ahead or giving up?

The supply of organs for transplant remains inadequate to meet the needs of waiting patients, in spite of many programs and approaches to increase rates of donation. Over the years there have been numerous proposals to introduce schemes that would move toward the outright sale of organs. Three articles in this issue of the Journal propose methods for increasing organ supply--two by moving toward a market approach and the third by advocating a change in social culture. All three suffer from shortcomings, including the endorsement and encouragement of the exploitation of those who may offer organs. Although the shortage of organs must be addressed, the social price of a market in organs is too high, and proposals to encourage a rethinking of social responsibility are unlikely to be effective.     

Affective Synchrony in Dual‐ and Single‐Smoker Couples: Further Evidence of “Symptom‐System Fit”?

Couples in which one or both partners smoked despite one of them having a heart or lung problem discussed a health-related disagreement before and during a period of laboratory smoking. Immediately afterwards, the partners in these 25 couples used independent joysticks to recall their continuous emotional experience during the interaction while watching themselves on video. A couple-level index of affective synchrony, reflecting correlated moment-to-moment change in the two partners' joystick ratings, tended to increase from baseline to smoking for 9 dual-smoker couples but decrease for 16 single-smoker couples. Results suggest that coregulation of shared emotional experience could be a factor in smoking persistence, particularly when both partners in a couple smoke. Relationship-focused interventions addressing this fit between symptom and system may help smokers achieve stable cessation.     

Commentary on “Night Cries: A Rural Tragedy” by Tracey Moffatt and Discussion of “States of Exile and Marginalization” by Gillian Straker

This is an excerpt of the work that I presented in Sydney last May at the International Association for Relational Psychoanalysis and Psychotherapy Conference “From the Margins to the Centre: Contemporary Relational Perspectives” in my capacity as discussant of Gill Straker’s work, which included the viewing of the film Night Cries by Tracey Moffatt. I focused on the relationships that are characterized by abuse of power, by inequalities that define interpersonal relationships, and by the type of trauma that ensues from them and on the ways and possibilities to find a way out, a method to reconcile with the victims.     

Family Characteristics and Posttraumatic Stress Disorder: A Follow-Up of Israeli Combat Stress Reaction Casualties

This study assessed the role of family status and family relationships in the course of combat-related posttraumatic stress disorder (PTSD). The sample consisted of 382 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War. Results showed that one year after the war married soldiers had higher rates of PTSD than did unmarried soldiers. Furthermore, higher rates of PTSD were associated with low expressiveness, low cohesiveness, and high conflict in the casualties' families. Theoretical, methodological, and clinical implications are discussed.     

Preschoolers with Asthma: Narratives of Family Functioning Predict Behavior Problems

This study tested a model predicting behavior symptoms in preschoolers with asthma. Specifically, it examined the role that asthma severity and children's representations of family functioning may play in the development of child behavior problems in a sample of 53 low-income preschoolers. The study included parent report of asthma severity and a narrative story-stem method to assess children's representations of both general and disease-specific family processes. A regression model tested the inclusion of both types of family processes in predicting child internalizing and externalizing behavior. Disease severity and children's family narratives independently predicted children's behavior over and above the combined effects of demographic variables including child age, socioeconomic status, and family structure. Although children's narratives about general family functioning predicted children's behavior, narratives about family response to asthma symptoms did not. Findings support that both disease severity and family functioning are important considerations in understanding children's behavior problems in the context of asthma. Clinical applications of findings may include: (1) Informing family based-assessments to incorporate children's narratives, and (2) A focus on reducing asthma symptoms and strengthening family functioning to prevent or address child behavior problems.     

Capturing Children's Response to Parental Conflict and Making Use of It

To read this article's abstract in both Spanish and Mandarin Chinese, please visit the article's full-text page on Wiley InterScience ( http://interscience.wiley.com/journal/famp ).
The aim of our study is to examine the interface between children's physiological changes and the specificities of parental conflict, and to develop a procedure in which such information can be shared with the family for therapeutic change. Children from 20 families were exposed to parental conflict discussion (CD) while their arousals were measured through skin conductance and heart rate sensors. It was found that regardless of the subject of the argument, 80% of the time they were complaining about each other. Likewise, 80% of the time the children were responding to the parents' own interpersonal tension, including moments of silence. The protocol established for the study, consisting of CD and debriefing, was found to be a powerful tool in moving parents toward conflict resolution.