Cultural specificity of support sources,correlates and contexts: Three studies of African-American and Caucasian youth

Levels and correlates of parental support, peer support, partner support, and/or spiritual support among African American and Caucasian youth were examined in three contexts: adolescent pregnancy (Study 1), first year of college (Study 2), and adolescence and young adulthood (ages 15–29; Study 3). Partially consistent with a cultural specificity perspective, in different contexts different support sources were higher in level and/or more strongly related to adjustment for one ethnic group than the other. Among pregnant adolescents, levels of spiritual support were higher for African Americans than Caucasians; additionally, peer support was positively related to well-being only for African Americans whereas partner support was positively related to well-being only for Caucasians. Among college freshmen, family support was more strongly related to institutional and goal commitment for African Americans than Caucasians; conversely, peer support was more strongly related to institutional and goal commitment among Caucasians. Among 15 to 29-year-olds, levels of parental support and spiritual support were higher among African Americans than Caucasians; additionally, spiritual support was positively related to self-esteem for African Americans but not for Caucasians. Implications and limitations of the research are discussed. The third study was supported by National Institute of Mental Health Grant RO1 MH40963. We thank Monica Greene, Shea Lyda, Wendy Stevenson, and the many undergraduate students who contributed to the three research projects. We also acknowledge the very thoughtful and helpful comments of the anonymous reviewers and the editor, Edison Trickett.     

Nine Experts Describe the Essence of Rational-Emotive Therapy While Standing on One Foot

The purpose of this study was to determine the extent of agreement among a panel of rational-emotive therapy (RET) experts about the essence of RET. The panel of experts consisted of the 9 members of The International Training Standards and Review Committee of the Institute for Rational-Emotive Therapy in New York. The question that the experts were asked was an adaptation of a Talmudic story known in Jewish lore as “While Standing on One Foot.” Responses were assigned to either of 2 categories: general cognitive behavior therapy (CBT) or RET-specific. There seems to be a range of responses that capture the essence of RET. A strong case can be made for subsuming many aspects of CBT under RET because much of what is associated with CBT has its origins in RET. The confusion about where RET ends and general CBT begins goes to the very heart of RET's status today.     

Case vignette: cybertherapy

Dr. Neuro Transmitter, a psychotherapist in Paramus, New Jersey, provides services through an online, real-time consultation service known as CyberShrink, Inc., of Dallas, Texas. He is paid by the hour for his consultation services to subscribers who are billed by credit card through CyberShrink. One afternoon he logs on and is connected via private "chat channel" to a new subscriber to the service. She is Ann Hedonia of Simi Valley, California. Ten minutes into the session, Dr Transmitter recognizes that Ms. Hedonia is seriously depressed with suicidal ideation and is feeling on the edge of her ability to cope. He gently suggests that perhaps she ought to think about hospitalization near her home. Ms. Hedonia replies, "Even you don't care about me! That's it. I'm going to do it!" and disconnects. Discussion questions: Is offering psychotherapy services online ethical? What are Dr. Transmitter's obligations in general and at this particular moment to Ms. Hedonia? Suppose Ms. Hedonia has a complaint about Dr. Transmitter. From whom can she seek a remedy? Which state's laws apply regarding professional practice, confidentiality, or licensing qualifications? Must Dr. Transmitter be licensed in any state to offer this service?     

Do the bishops have it right on health care reform?

The National Conference of Catholic Bishops has argued for significant government involvement in health care in order to assure respect for what they regard as the right to health care. Critics charge that the bishops are wrong because health care is not a right. In this article, it is argued that these critics are correct in their claim that health care is not a right. However, it is also argued that the premise that health care is not a right does not imply that the market is the most equitable and just system for providing health care. Natural law arguments in the tradition of Roman Catholic social teaching lead to the conclusion that a just and prosperous society has a moral obligation to provide health care even if there is no such right. Further, there are strong moral grounds for concluding that the bishops are correct in their claim that health care ought not to be considered a market commodity. It is argued that if health care ought not to be considered a commodity, then national health insurance is the best available alternative for fulfilling the social obligation to distribute health care resources justly and fairly at this time in American history. The bishops' case for government involvement can be made on the strength of the Catholic tradition in theological argumentation, independent of the claim that health care is a right.     

Competing interests: The need to control conflict of interests in biomedical research

Individual and institutional conflict of interests in biomedical research have becomes matters of increasing concern in recent years. In the United States, the growth in relationships — sponsored research agreements, consultancies, memberships on boards, licensing agreements, and equity ownership — between for-profit corporations and research universities and their scientists has made the problem of conflicts, particularly financial conflicts, more acute. Conflicts can interfere with or compromise important principles and obligations of researchers and their institutions, e.g., adherence to accepted research norms, duty of care to patients, and open exchange of information. Disclosure is a key component of a successful conflict policy. Commitments which conflict with a faculty member's primary obligations to teaching, research, administrative responsibilities, or patient care also need attention. Institutional conflict of interests present different problems, some of which are discussed in an analysis of an actual problem posed by two proposed clinical trials. This paper is adapted from a lecture presented to a Symposium on Scientific Integrity, Warsaw, Poland, 23 November 1995. Daniel Steiner was Vice-President and General Counsel of Harvard University (1972–92) and in that capacity became familiar with conflict of interest issues. He is currently Counsel to the Boston law firm. Ropes and Gray, and is Adjunct Lecturer in Public Policy at the John F. Kennedy School of Government. Harvard University.     

Prepulse effects on magnitude estimation of startle-eliciting stimuli and startle responses

The present studies investigated the relationship between prepulse effects on the modification of the brainstem startle reflex and magnitude estimates of startle-eliciting stimuli. In Experiment 1, startle eyeblink responses were elicited in 24 students, half of whom were instructed to estimate the loudness of the startle stimulus (actual intensities of 80, 90, and 100 dB) and half of whom were instructed to estimate the magnitude of their eyeblink. When weak acoustic prepulses preceded the startle-eliciting stimulus, eyeblink amplitude was inhibited, and estimates of response magnitude decreased, but estimates of startle stimulus magnitude decreased only when 100-dB startle stimuli were presented. In Experiment 2, the same startle stimuli were preceded on some trials by a vibrotactile prepulse to the hand. In conditions in which startle amplitude was inhibited, startle stimulus magnitude estimates were not affected. This suggests that the effect of acoustic prepulses on 100-dB startle stimuli in Experiment 1 may have been due to loudness assimilation, an effect independent of the prepulse inhibition of startle responding.     

Matching adolescents with foster mothers and fathers: An evaluation of the role of temperament

We tested the notion that better foster care adjustment would be observed when the temperaments of mothers and fathers were matched with those of adolescent foster children. We hypothesized that families in which foster parents and foster children had high (easy) scores on subscales of the Revised Dimensions of Temperament Scale (DOTS-R) would also report higher family functioning and higher foster care adjustment than parents and children from families in which one or both family members had low (difficult) scores on these scales. The hypotheses were supported when the mothers and fathers family assessments were used but rejected when the observations of the case managers and adolescents were tested. Methodological and substantive explanations for the findings are discussed and recommendation for foster care practice and continuing research are provided.     

Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Monogeusia for fructose,glucose, sucrose,and maltose

We investigated the ability of subjects to discriminate sugars with a whole-mouth forced-choice paradigm, in which a standard solution was compared with a test solution of varied concentration. Discrimination probabilities were U-shaped functions of test concentration: for 6 subjects and pairwise combinations of fructose, glucose, and sucrose, discriminability always declined to chance over a narrow range of test concentrations. At concentrations ≦ 100 mM, maltose was indiscriminable from fructose but discriminable at higher concentrations for 4 subjects. By analogy with themonochromacy of night vision, whereby any two lights are indiscriminable when their relative intensities are suitably adjusted, we call the gustatory indiscriminability of these sugarsmonogeusia. The simplest account of monogeusia is that all information about the indiscriminable sugars is represented by a single neural signal that varies only in magnitude. The discriminability of maltose from the other sugars at higher concentrations is consistent with the hypothesis that maltose also activates a second gustatory code.