PTSD,comorbid depression,and the cortisol waking response in victims of intimate partner violence: preliminary evidence

Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are two highly comorbid and debilitating disorders experienced by more than half of intimate partner violence victims (IPV). Hypothalamic–pituitary–adrenal (HPA) abnormalities are common in both disorders, though the direction of abnormalities often differs. The present study examined the relationship between comorbid PTSD and MDD, and the (salivary) cortisol waking response in 104 recently abused IPV victims. Waking cortisol levels, area under the waking curve with respect to ground (AUCg), and AUC with respect to increase (AUCi) were examined to determine the relation of HPA dynamics to comorbidity for basal versus more dynamic measures. Prior to accounting for comorbidity, women with PTSD or MDD showed significantly greater AUCi than women without the respective disorder. Accounting for comorbidity, PTSD only did not differ from other groups, while MDD only and PTSD + MDD showed greater AUCi than women with neither disorder. Results were nonsignificant for waking cortisol levels or AUCg. Results suggest that MDD drives elevated waking cortisol response, but not basal cortisol activity in recently abused IPV victims. Results demonstrate the importance of examining comorbid diagnoses and HPA activity from a dynamic perspective. Therapeutic implications are discussed.     

A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others

Recent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty’s philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors’ relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine.     

Subjective and Objective Aspects of Free Time: The Italian Case

This study investigates two distinct but interrelated phenomena—that of experienced leisure and that of perceived leisure—in order to determine empirically whether and how the perception and use of free time affects an individual’s level of satisfaction. The analysis was conducted on a sample of approximately 50,000 individuals, representative of the Italian population. It focused on the person-centred sphere of leisure: both the objective aspect—that is, participation in leisure activities—and the subjective aspects—that is, the different meanings of leisure and levels of satisfaction or dissatisfaction expressed by the subjects—were investigated. By applying multivariate analytical techniques (Multiple Correspondence Analysis and Cluster Analysis), synthetic indices were calculated and subject typologies were developed. Logistic regression models were also used to investigate the relationship between perception, activity and satisfaction. The results confirmed that the objective and subjective aspects are interrelated: there are specific activities related to the type of perception of leisure activities which contribute significantly to making a person happy. There are other aspects, however, such as relational activities and sports, which are important for the satisfaction of those whose conception of leisure seems discordant with respect to such activities.     

The Relative Importance and Interaction of Contextual and Methodological Predictors of Mean rWG for Work Climate

A variety of collective phenomena are understood to exist to the extent that workers agree on their perceptions of the phenomena, such as perceptions of their organization’s climate or perceptions of their team’s mental model. Researchers conducting group-level studies of such phenomena measure individuals’ perceptions via surveys and then aggregate data to the group level if the mean within-group agreement for a sample of groups is sufficiently high. Despite this widespread practice, we know little about the factors potentially affecting mean within-group agreement. Here, focusing on work climate, we report an investigation of a number of expected contextual (social interaction) and methodological predictors of mean r_WG, a common statistic for judging within-group agreement in applied psychology and management research. We used the novel approach of meta-CART, which allowed us to assess the relative importance and possible interactions of the predictor variables. Notably, mean r_WG values are driven by both contextual (average number of individuals per group and cultural individualism-collectivism) and methodological factors (the number of items in a scale and scale reliability). Our findings are largely consistent with expectations concerning how social interaction affects within-group agreement and psychometric arguments regarding why adding more items to a scale will not necessarily increase the magnitude of an index based on a Spearman-Brown “stepped-up correction.” We discuss the key insights from our results, which are relevant to the study of multilevel phenomena relying on the aggregation of individual-level data and informative for how meta-analytic researchers can simultaneously examine multiple moderator variables.

     

The Interaction Between Self-Regulation Deficits and Negative Problem Orientation Exacerbates Depressive,but not ADHD Symptoms

Journal of Rational-Emotive & Cognitive-Behavior Therapy - Self-regulation (SR) and negative problem orientation (NPO) have well-established, independent connections to psychopathology. Despite...     

Responding to the Psychological Needs of Health-Care Workers During the COVID-19 Pandemic: Case Study from the Medical College of Wisconsin

With the advent of the novel coronavirus (COVID-19) pandemic, health-care workers have been faced with an inordinately high level of trauma as frontline providers. The Medical College of Wisconsin (MCW) partnered with affiliate hospitals and community partners to mobilize a matrix of available support and interventions to deliver psychological services to reach all levels of health-care providers in timely, accessible formats. While virtual peer support groups were the most utilized resource among the support group options, other opportunities also provided unique benefits to learners whose education had been disrupted by the pandemic. Mental health must be prioritized for health-care workers in the event of future public health crises. Lessons learned from this pandemic indicate that it is critical to involve learners early on in the process in order to meet their educational needs and to increase access to evidence-based care.

     

Building phrases in language production: An MEG study of simple composition

Although research on language production has developed detailed maps of the brain basis of single word production in both time and space, little is known about the spatiotemporal dynamics of the processes that combine individual words into larger representations during production. Studying composition in production is challenging due to difficulties both in controlling produced utterances and in measuring the associated brain responses. Here, we circumvent both problems using a minimal composition paradigm combined with the high temporal resolution of magnetoencephalography (MEG). With MEG, we measured the planning stages of simple adjective–noun phrases (‘red tree’), matched list controls (‘red, blue’), and individual nouns (‘tree’) and adjectives (‘red’), with results indicating combinatorial processing in the ventro-medial prefrontal cortex (vmPFC) and left anterior temporal lobe (LATL), two regions previously implicated for the comprehension of similar phrases. These effects began relatively quickly (∼180 ms) after the presentation of a production prompt, suggesting that combination commences with initial lexical access. Further, while in comprehension, vmPFC effects have followed LATL effects, in this production paradigm vmPFC effects occurred mostly in parallel with LATL effects, suggesting that a late process in comprehension is an early process in production. Thus, our results provide a novel neural bridge between psycholinguistic models of comprehension and production that posit functionally similar combinatorial mechanisms operating in reversed order.     

Comparing Holographic Reprocessing and Prolonged Exposure for Women Veterans with Sexual Trauma: A Pilot Randomized Trial

This pilot study compares an emerging evidence-based treatment, holographic reprocessing (HR) to prolonged exposure (PE) versus a person-centered (PC) control group to treat symptoms of distress in female Veterans with sexual trauma. In contrast to PE, HR does not include exposure to a target event of trauma. Instead, HR focuses on healing the internal working model or type of attachment style that may form as a result of interpersonal trauma or maltreatment. The model reveals how people perceive themselves and others. These perceptions set in motion emotional, cognitive, and behavioral tendencies wherein people unconsciously replicate similar types of relationships that reinforce their worldview. Fifty-one female Veterans with sexual trauma were randomly assigned to one of three treatments and completed pre- and post-treatment measures of psychiatric symptoms (anxiety, depression, and PTSD) and post-traumatic cognitions. ANOVAs found significant decreases on all variables. Post-hoc comparisons revealed that HR and PE treatments demonstrated significantly greater decreases in symptoms compared to the PC control group. Chi square analyses revealed that HR produced a significantly lower dropout rate 1 (6 %) compared to PE 7 (41 %) and PC 6 (35 %). These initial results are promising and further investigation of HR is warranted.     

Spirituality in Occupational Therapy: Do We Practice What We Teach?

This mixed-method study examined the responses of 97 occupational therapists on the subject of spirituality in occupational therapy practice. The inclusion of spirituality into the Occupational Therapy Practice Framework (2008) implies that clinicians address spirituality as a component of client-centered practice. This research revealed a gap between education, theory, and practice as evidenced in the quantitative and qualitative data. Although occupational therapy is intended to be holistic, therapists require a more complete understanding of what spirituality is and what the role of the occupational therapist is when addressing spirituality in evaluation or treatment. The discussion of this research provides information for future occupational therapy educators and educational programs as they seek to incorporate the construct of spirituality into curricula.