Vulvar pain: a phenomenological study of couples in search of effective diagnosis and treatment

Vulvar vestibulitis syndrome (VVS), a vulvar pain disorder, continues to puzzle medical and mental health professionals due to its unknown etiology and lack of effective treatment. This study used transcendental phenomenology methodology to explore the experiences of couples in which the woman has a diagnosis of VVS. Sixteen in-depth semi-structured interviews were conducted with 13 heterosexual couples and 3 women. Four essences emerged: (1) In search of ... the medical journey required extensive searching for knowledgeable and respectful practitioners to provide treatment. (2) The process of developing a personal understanding of this disorder led many couples to question their role in causing and maintaining VVS. (3) Developing strategies for coping with painful intercourse led to three strategies: becoming non-sexual, using alternatives to vaginal sex, and altering or enduring painful intercourse. (4) Feelings of isolation were experienced as adapting to this chronic pain syndrome was often a lonely process. Clinical suggestions included: treating the couple, not just the woman with VVS; encouraging couples to broaden definitions about the importance and primacy of vaginal intercourse and suggest alternative sexual activities less likely to cause vulvar pain; developing shared meaning as a couple, and assisting couples in locating physicians and resources. Suggestions are relevant for couples with VVS and those with chronic health problems affecting sexual relationships.     

Mapping moral motives: Approach, avoidance, and political orientation

Recent critiques of moral psychology and the contemporary culture wars highlight the need for a better understanding of diverse moral perspectives. A model of moral motives is proposed. The fundamental approach–avoidance distinction in motivation is crossed with self-other focus to create four moral motives: Self-Restraint (avoidance-self), Social Order (avoidance-other), Self-Reliance (approach-self), and Social Justice (approach-other). Three studies explored these motives in the context of political orientation. Overall, political conservatism was associated with avoidance motives and liberalism with approach motives. Approach–avoidance motives were also associated with distinct patterns of results regarding authoritarianism, social dominance, and positions on contemporary social issues. Responses of campus political groups demonstrated the utility of the moral motives in providing a more nuanced view of politics that also takes into account the model’s second dimension, for an emphasis on Self focus (personality responsibility) versus Other focus (social responsibility) further distinguished between conservative groups. Moral and political implications are discussed.     

Connection to Early Church Theologians: Canadian Ethnographic Study on the Similarities and Differences between Prayer and Theological Reflection in Pastoral Care and Counseling

What are the similarities and differences between prayer and theological reflection in the praxis of pastoral care and counseling? This qualitative study is ethnographic in design. A review of the literature is summarized. Researchers interviewed 75 participants in four cultures: (1) chaplains and (2) pastoral counselors in the Canadian Association of Pastoral Practice and Education (CAPPE), (3) community clergy and persons in lay ministry, and (4) students after internship in a theological reflection course. Interviews were audiotaped, transcribed and then coded for themes. Findings include seeing more similarities than differences between prayer and theological reflection. One of the differences is that prayer is more affective and theological reflection is more cognitive. There are also some areas of ambiguity. Discussion includes what ought to be normative or the orthopraxis for prayer and theological reflection in pastoral care and counseling. Limitations and areas for future research are outlined.     

Testing a Gender Additive Model: The Role of Body Image in Adolescent Depression

Despite consistent evidence that adolescent girls are at greater risk of developing depression than adolescent boys, risk factor models that account for this difference have been elusive. The objective of this research was to examine risk factors proposed by the gender additive model of depression that attempts to partially explain the increased prevalence of depression in adolescent girls. The theory suggests that body image and eating related variables predict depression for girls, but not for boys, above and beyond the variance accounted for by other well-known risk factors, some of which were examined in the current study. The sample was 247 adolescent girls and 181 adolescent boys studied over a 24-month duration. Results suggest that body dissatisfaction is a potent predictor of depression for girls, but not for boys, above and beyond the predictive effects of other established risk factors. Results provide insight into the etiology of adolescent depression and the disparate rate of depression among adolescent girls and provide direction for identifying high-risk individuals and developing effective prevention programs.     

Temperament and Parenting during the First Year of Life Predict Future Child Conduct Problems

Predictive associations between parenting and temperament during the first year of life and child conduct problems were assessed longitudinally in 1,863 offspring of a representative sample of women. Maternal ratings of infant fussiness, activity level, predictability, and positive affect each independently predicted maternal ratings of conduct problems during ages 4–13 years. Furthermore, a significant interaction indicated that infants who were both low in fussiness and high in predictability were at very low risk for future conduct problems. Fussiness was a stronger predictor of conduct problems in boys whereas fearfulness was a stronger predictor in girls. Conduct problems also were robustly predicted by low levels of early mother-report cognitive stimulation when infant temperament was controlled. Interviewer-rated maternal responsiveness was a robust predictor of conduct problems, but only among infants low in fearfulness. Spanking during infancy predicted slightly more severe conduct problems, but the prediction was moderated by infant fussiness and positive affect. Thus, individual differences in risk for mother-rated conduct problems across childhood are already partly evident in maternal ratings of temperament during the first year of life and are predicted by early parenting and parenting-by-temperament interactions.

Psychological Factors Associated with Emotional Responses to Receiving Genetic Risk Information

This study identified levels of distress, and predictors of levels of distress, in women undergoing assessment for genetic risk of breast/ovarian cancer based on their family history. It comprised a cohort study following 154 women who completed questionnaires at entry into a cancer genetic assessment programme and following risk provision. Independent significant associates of anxiety following risk provision were age, neuroticism, feeling hopeless about developing cancer, a perceived lack of control over developing cancer, lack of a social confidant, and a coping response involving acceptance/resignation. Depression was associated with age, neuroticism, feeling hopeless about developing cancer, lack of social confidant, and a coping response involving acceptance/resignation. To avoid high levels of psychological morbidity in future cohorts undergoing cancer genetic risk assessment, information should be given that emphasises that some degree of control over health outcomes through behaviour change or increased surveillance is possible.     

Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol

Pain, spasticity, tremor, spasms, poor sleep quality, and bladder and bowel dysfunction, among other symptoms, contribute significantly to the disability and impaired quality of life of many patients with multiple sclerosis (MS). Motor symptoms referable to the basal ganglia, especially paroxysmal dystonia, occur rarely and contribute to the experience of distress. A substantial percentage of patients with MS report subjective benefit from what is often illicit abuse of extracts of the Cannabis sativa plant; the main cannabinoids include delta-9-tetrahydrocannabinol (delta9-THC) and cannabidiol. Clinical trials of cannabis plant extracts and synthetic delta9-THC provide support for therapeutic benefit on at least some patient self-report measures. An illustrative case is presented of a 52-year-old woman with MS, paroxysmal dystonia, complex vocal tics, and marijuana dependence. The patient was started on an empirical trial of dronabinol, an encapsulated form of synthetic delta9-THC that is usually prescribed as an adjunctive medication for patients undergoing cancer chemotherapy. The patient reported a dramatic reduction of craving and illicit use; she did not experience the "high" on the prescribed medication. She also reported an improvement in the quality of her sleep with diminished awakenings during the night, decreased vocalizations, and the tension associated with their emission, decreased anxiety and a decreased frequency of paroxysmal dystonia.     

Ubiquity of Whiteness in majority group national imagination: Australian = White,but New Zealander does not

This research examined cross‐national differences in the extent to which majority ethnic group members (White Europeans) in Australia and New Zealand automatically privileged members of their ingroup, relative to Indigenous targets, in cognitive representations of nationhood. As predicted, European Australian undergraduates implicitly associated their own ethnic group with the concept of “Australian”, relative to Aboriginal Australian targets (N = 50), but the implicit preferencing of Whiteness in representations of nationhood (relative to Maori targets) was absent in a comparable sample of New Zealand European undergraduates (N = 50). These results indicate that the extent to which representations of minority groups are interwoven with non‐conscious cognitive representations of nationhood and national identity are not immutably fixed. Instead, it is argued that this cross‐national difference is due to underlying systemic differences in the extent to which symbolic markers of Indigenous culture, identity, and values are consensually represented in majority group (White) national culture.