The paradox of healing pain

Pain may be seen as a problem to be healed or as a means for healing. The secular biomedical view of pain is that it is to be avoided and alleviated; its only meaning is as a symptom of underlying disease. In contrast, there have been throughout history other views of suffering—as redemptive or as transformative, for example. This paper considers the disparity between these perspectives, examining the role of the emotions and the underlying neurobiological processes though which pain and suffering come to be experienced as meaningful, then analyzes interview material exploring how religion and religious beliefs help people cope with suffering or with pain. The experience of pain is subjective, enculturated experience; the meaning that pain or suffering holds within a given cultural context affects the experience of pain and suffering. In a context where pain and suffering are understood to be valuable, those experiences can be used for spiritual transformation and integrated within a meaningful identity. In contrast, in a context where pain and suffering are not understood to have value, that attitude can create more suffering, even in conditions meant to alleviate suffering, such as in biomedical situations.     

Provision of Genetic Services for Hearing Loss: Results from a National Survey and Comparison to Insights Obtained from Previous Focus Group Discussions

Hearing loss is a common sensory deficit and more than 50% of affected individuals have a genetic etiology. The discovery of 40 genes and more than 100 loci involved in hearing loss has made genetic testing for some of these genes widely available. Genetic services for deafness are also being sought more often due to the early identification of hearing loss through newborn screening services. The motivations for pursuing genetic testing, and how genetic services are provided to the client may differ among individuals. Additionally, information obtained through genetic testing can be perceived and used in different ways by parents of deaf children and deaf adults. This study aimed to follow up on focus group studies published earlier with a quantitative survey instrument and assess the preference of consumers for provision of genetic services. We conducted a national survey of hearing and deaf parents of children with hearing loss and of deaf adults. Data was compared and analyzed by hearing status of the participant, their community affiliation and the genetic testing status using nominal logistic regression. Consistent with our focus group results, the survey participants thought that a genetic counselor/geneticist would be the most appropriate professional to provide genetics services. Statistically significant differences were noted in the preferred choice of provider based on the genetic testing status. Parents preferred that genetic evaluation, including testing, occur either immediately at or a few months after the audiologic diagnosis of hearing loss. This data should help providers in clinical genetics keep patient preferences at the helm and provide culturally competent services.     

Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients.

This study evaluated the psychometric characteristics of the Beck Depression Inventory-II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in a primary care medical setting. A principal-components analysis with Promax rotation indicated the presence of 2 correlated factors, Somatic-Affective and Cognitive, which explained 53.5% of the variance. A hierarchical, second-order analysis indicated that all items tap into a second-order construct of depression. Evidence for convergent validity was provided by predicted relationships with subscales from the Short-Form General Health Survey (SF-20; A. L. Stewart, R. D. Hayes, & J. E. Ware, 1988). A receiver operating characteristic analysis demonstrated criterion-related validity: BDI-II scores predicted a diagnosis of major depressive disorder (MDD), as determined by the Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ). This study demonstrated that the BDI-II yields reliable, internally consistent, and valid scores in a primary care medical setting, suggesting that use of the BDI-II in this setting may improve detection and treatment of depression in these medical patients.     

Evaluation of self-administered rational emotive therapy programs for interpersonal anxiety

Self-administered rational emotive therapy (RET), withA New Guide to Rational Living (Ellis & Harper, 1975), as the treatment manual, was evaluated by comparing three groups which varied in terms of therapist contact (therapist administered, minimal contact, self-administered). University students who volunteered for the research program involving the treatment of interpersonal anxiety were randomly assigned to one of these treatments or to a wait-list control group. The results for 72 subjects who completed the 5-week program indicated the three treatment groups made significant gains over untreated controls on some of the self-report measures. No between-group differences appeared on ratings by significant others. A four- to five-month follow-up, which obtained data from 41 (58%) of the subjects, provided some support for the maintenance of treatment effects for the therapist administered and minimal contact groups. Correlations of assessed irrational beliefs with outcome measures provided some support for the RET model.Norris D. Vestre, Ph.D., is a Professor in the Department of Psychology, Arizona State University. Terrence J. Judge, M.C., R.N.C., is a nurse therapist at Camelback Vista Treatment Center, Scottsdale, Arizona.     

The Morning After: Gender Differences In Attributions About Alcohol-Related Sexual Encounters1

Traditional sex role characteristics suggest that women may be more dissatisfied with casual sex than men. We investigated this notion by examining the reactions of women and men to a hypothetical, first-time sexual encounter. An additional factor that was hypothesized to affect reactions was the presence of alcohol, which may serve as a cue for sexual disinhibition. College students read a scenario depicting a consensual sexual encounter between two people who met at a party, and made judgments about the partners' behavior and characteristics. Four versions of the scenario varied the alcohol consumption of both characters. Results showed that men were more likely than women to find the behavior of each partner socially acceptable, to foresee a positive future for the couple as a result of their sexual encounter, and to predict that they themselves would engage in similar behavior. Although no main effects for alcohol consumption were found, alcohol consumption interacted with gender to influence judgments about the characters' sexuality. Results are discussed in terms of sex role stereotyping and the tendency of both sexes to misunderstand or misperceive each other's sexual feelings.     

DATING, DRINKING, AND RAPE: Effects of Victim's and Assailant's Alcohol Consumption on judgments of Their Behavior and Traits

Effects of an acquaintance rape victim's and her assailant's alcohol consumption on judgments of their behavior and traits were examined in a 2 × 2 × 2 between-subjects factorial experiment. Sixty-eight women and 64 men, 21 or older, read one of four stories in which only the victim, only the assailant, both victim and assailant, or neither victim nor assailant consumed alcohol. One individual difference trait, rape attitudes, was also measured. The interaction of victim and assailant drinking diminished the view that a rape had occurred and that the victim responded negatively, whereas it enhanced judgments of the assailant's likability and sexuality. The portrayal of only the victim drinking resulted in a more negative view of the assailant's behavior and traits. Evaluations of the victim depended on the assailant's drinking behavior rather than on her own. Implications for treatment of rape victims and establishing assailant accountability are discussed.     

WOMEN'S APPRAISALS OF SEXUAL-ASSAULT RISK IN DATING SITUATIONS

This study investigated how 165 female college students appraised their sexual-assault risk in a hypothetical dating situation. A 2 × 2 × 2 between-subjects experiment investigating the effects of male-dating-partner characteristics, story character beverage consumption, and perspective on women's risk appraisals was conducted. Multivariate analyses of variance were performed to test hypotheses regarding the feelings of the dating woman and the occurrence of sexual behaviors. Although the dating woman was rated as feeling more vulnerable on dates when alcohol was consumed, alcohol consumption did not influence ratings regarding the dating man committing nonconsensual sexual acts. Nonconsensual sexual behaviors were rated as more probable when the man had rape-congruent characteristics and when the participants were judging another woman rather than themselves. These findings suggest that women are partially accurate in making sexual-assault risk appraisals and thus may benefit from rape prevention education that specifically targets their inaccuracies.     

Ontology According to van Fraassen: Some Problems with Constructive Empiricism

This paper argues the case for ontological realism as against various present-day forms of conventionalist, instrumentalist, cultural-relativist, or anti-realist doctrine. In particular it takes issue with Richard Rorty's writings on philosophy of science – where these ideas receive their most extreme and provocative statement – and with Bas van Fraassen's more moderate 'constructive empiricist' approach. This latter entails ontological commitment to whatever shows up through trained observation or empirical research. However, it refuses to countenance realist claims concerning the existence of (as yet) unobserved entities and their role in explanatory theories premised on putative laws of nature. I maintain that van Fraassen's position is: (1) inadequate to account for our knowledge of the growth of scientific knowledge; (2) self-refuting since often undermined by examples which he himself supplies; and (3) incapable of mounting resistance to other, more wholesale (e.g., Rortian) varieties of anti-realist argument. Only by combining causal realism with a principle of inference to the best explanation can philosophy of science avoid these kinds of hyperinduced sceptical doubt.     

Differences Between Rape Victims Who Report and Those Who Do Not Report to a Public Agency1

The purpose of this study was to identify the variables that predict whether or not a rape victim will report to either a social service agency and/or the police. One hundred seventy-nine female rape victims who either reported or did not report completed a questionnaire that assessed (1) perceived outcomes of reporting a rape, (2) social expectations to report or not report, (3) individual characteristics of the victim, and (4) situational characteristics of the rape. Perceived outcomes, social expectations, and certain situational characteristics effectively predicted reporting behavior. Theoretical explanations for the findings and implications for increasing the likelihood that victims will report are discussed.