Health Beliefs and Practices in an Isolated Polygamist Community of Southern Utah

Short Creek is a largely closed and isolated community on the border between Utah and Arizona, made up of the sister towns of Hildale, Utah, and Colorado City, Arizona. Beginning from childhood, the 6,000 or so members of the Fundamentalist Church of Jesus Christ of Latter-Day Saints (FLDS) are brought up in a lifestyle of plural marriage, meaning a marriage among one man and more than one woman, and are surrounded by their peers in “the covenant.” A lifestyle of plural marriage is likely to affect the health of community members, but its effects have not been studied because of the community’s isolation and distrust of outsiders. This paper addresses several questions that arise in contemplating the health of the Short Creek community: What are the health beliefs in this community, and what are their historical bases? Where do families seek medical care, and for what or at what threshold of illness or injury? What is the attitude of care providers serving this community, and how are the providers viewed by the community? More broadly, this paper examines the ways in which polygamy configures health. In order to meet this objective, this paper aims first to provide a brief account of this community’s history and demographic profile, followed by a discussion of health care in this community and how it is affected by the practice of plural marriage, with the data comprised of qualitative interviews with health care providers to the community. The goals of this project are to gain a rich, historically nuanced understanding of the health of community members, and to identify directions for further academic and policy research. Our findings indicate that health in this community is shaped by limited resources, an attitude of health fatalism, and a profound insularity and corresponding isolation from the outside world.     

The role of ethnocultural variables in response to terrorism

The threat of terrorism is having a profound impact on Americans. This study examined ethnocultural variables of ethnic background, gender, age, and educational background to better understand first reactions to, explanations for, and responses to what happened on September 11, 2001. Data were obtained from a sample of university students, church and civic group members, and people of the general community. Results suggest that ethnic background, gender, and age influence reactions to terrorism. Ethnic background and gender influenced causal explanations about the attacks. Strong gender differences were noted in how participants were affected by the attacks; strongest similarities were observed in reports of first reactions to news of the events, with most people experiencing shock and disbelief. Conclusions stress the importance of future mental health interventions and research giving strong consideration to ethnocultural variables when dealing with victims of terrorism.     

What works in prevention. Principles of effective prevention programs

The high prevalence of drug abuse, delinquency, youth violence, and other youth problems creates a need to identify and disseminate effective prevention strategies. General principles gleaned from effective interventions may help prevention practitioners select, modify, or create more effective programs. Using a review-of-reviews approach across 4 areas (substance abuse, risky sexual behavior, school failure, and juvenile delinquency and violence), the authors identified 9 characteristics that were consistently associated with effective prevention programs: Programs were comprehensive, included varied teaching methods, provided sufficient dosage, were theory driven, provided opportunities for positive relationships, were appropriately timed, were socioculturally relevant, included outcome evaluation, and involved well-trained staff. This synthesis can inform the planning and implementation of problem-specific prevention interventions, provide a rationale for multi-problem prevention programs, and serve as a basis for further research.     

I copy you as I believe you know about our culture: Combining imitation and selective trust literatures

Empirical findings and theorizations of both imitation and selective trust offer different views on and interpretations of children's social learning mechanisms. The imitation literature provides ample documentation of children's behavioural patterns in the acquisition of socially appropriate norms and practices. The selective trust literature provides insights into children's cognitive processes of choosing credible informants and what information to learn in future interactions. In this paper, we place together findings from both fields and note that they share analogically similar theoretical underpinnings and offer explanations that are complementary to each other. We contend that children's imitative tendency may be due to their selection of in-group members as cultural experts, who serve as reliable sources of conventional information. Moving forward, we note the importance of evaluating individual differences and cultural factors to provide a more holistic understanding of universality and variation in children's social learning mechanisms.     

Motivated recruitment of autobiographical memories

We hypothesized that people motivated to believe that they possess a given trait search for autobiographical memories that reflect that trait, so as to justify their desired self-view. We led subjects to believe that either extraversion or introversion was desirable, and obtained convergent evidence from open-ended memory-listing tasks as well as from reaction-time tasks measuring the speed with which memories could be generated that this manipulation enhanced the accessibility of memories reflecting the desired trait. If people rely on their memories to construct desired self-concepts, motivated changes in self-concepts should be constrained by the content of available memories. Our final study demonstrates such constraints.     

Assessment and DSM-IV Diagnosis of Personality Disorders: A Primer for Counselors

The DSM-IV categorizes 10 personality disorders, long-term patterns of personality traits that result in impairment of social and occupational functioning. The author details steps in the recognition and diagnosis of personality disorders, with emphasis on using the DSM-IV diagnostic framework.     

Left ventricular assist devices: An ethical analysis

United States statistics continue to indicate that the human donor heart pool does not and will not meet the great demand for hearts. For those patients unresponsive to maximal medical therapy (approximately 60,000 patients per year), cardiac transplantation is currently their best hope for increased survival. To address the need for additional end-stage congestive heart failure (CHF) therapy options, three medical device manufacturers have developed implantable left ventricular assist devices (LVAD) which act as a pump for hemodynamic support of the patient’s diseased heart. Although LVADs have been shown to improve patient disease state prior to organ transplantation. LVADs do nothing to increase the pool of human donor hearts, and they negatively impact the United Network for Organ Sharing (UNOS) waiting list by increasing the size of the waiting pool. This paper identifies and explores the ethical challenges presented by the use of LVADs as a bridging technology for heart transplant candidates. Although LVADs raise some ethical concerns, these concerns are outweighed by the proven medical efficacy of these devices. Thus, this technology should continue to be used and further developed. This paper was written by the author while in the Masters degree progrm at Loma Linda University (Dept. of Biomedical and Clinical Ethics), 11234 Anderson Street, Coleman Pavillion, Loma Linda, CA 92354, USA. The author is currently an Ethies Fellow (pre-doctoral) in UCLA’s program in Biomedical and Research Ethics.     

A PERFORMANCE-BASED LOTTERY TO IMPROVE RESIDENTIAL CARE AND TRAINING BY INSTITUTIONAL STAFF

Two experiments were conducted on four units of a residential facility for the multiply-handicapped retarded in an attempt to improve daily care and training services. Experiment I compared the effects of two procedures in maintaining the work performance of attendants, using an A-B design on two units. One procedure consisted of implementing specific staff-resident assignments, the other consisted of allowing attendants who had met performance criteria to be eligible for a weekly lottery in which they could win the opportunity to rearrange their days off for the following week. Results showed that the lottery was a more effective procedure as measured by the per cent of time attendants engaged in predefined target behaviors, and by their frequency of task completion in several areas of resident care. Experiment II replicated and extended these results to the area of work quality on two additional units, using a multiple-baseline design. The performance lottery was found to be an effective economical procedure that could be implemented by supervisory staff on a large scale.     

Electroencephalographic asymmetries in adolescents with major depression: influence of comorbidity with anxiety disorders

This study examined whether adolescents with major depressive disorder (MDD) display the abnormal electroencephalographic (EEG) alpha asymmetries found in depressed adults. Resting EEG was recorded in 25 right-handed female outpatients (19 with MDD, 11 of whom also had a current anxiety disorder; 6 with anxiety disorders only) and 10 non-ill controls. In contrast to the non-ill controls, adolescents having MDD but no anxiety disorder showed alpha asymmetry indicative of less activation over right than over left posterior sites. Within the MDD patient group, comorbid anxiety disorders reduced the posterior alpha asymmetry, supporting the potential importance of evaluating anxiety in studies of regional brain activation in adolescent MDD. These preliminary findings are similar to those from adult studies that suggest that MDD is associated with right parietotemporal hypoactivation.