Behavioral Health Services ��Don��t Work for Us��: Cultural Incongruities in Human Service Systems for Alaska Native Communities

Community psychology emphasizes the importance of context in the study of people's lives, and culture influences this in profound ways. To develop programs that effectively address diverse communities' problems, it is essential to recognize how Euro-American human service systems are understood and responded to by the many different people being served by them. The article describes how some broadly defined social services-conceptualized and implemented within a Euro-American framework-are ill suited for the everyday realities of Alaska Native villages. The cultural discontinuities are illustrated through ethnographic vignettes. The article concludes with suggestions for developing more culturally-responsive ways to conceive of and do programming for Alaska Native and possibly other Indigenous and minority communities.     

Subjects Without a World? An Husserlian Analysis of Solitary Confinement

Psychiatrist Stuart Grassian has proposed the term “SHU syndrome” to name the cluster of cognitive, perceptual and affective symptoms that commonly arise for inmates held in the Special Housing Units (SHU) of supermax prisons. In this paper, I analyze the harm of solitary confinement from a phenomenological perspective by drawing on Husserl’s account of the essential relation between consciousness, the experience of an alter ego and the sense of a real, Objective world. While Husserl’s prioritization of transcendental subjectivity over transcendental intersubjectivity underestimates the degree to which first-person consciousness is constitutively intertwined with the embodied consciousness of others, Husserl’s phenomenology nevertheless provides a fruitful starting-point for a philosophical engagement with the psychiatric research on solitary confinement.     

Examining the Use of Sex to Cope in a Forensic Sample

The authors examined differences between sexual and mentally disordered offenders on the Coping Using Sex Inventory. Sexual offenders were more likely to use sex to cope with negative life events but did not use all forms of deviant sexual activity.     

Longitudinal Interviews of Couples Diagnosed with Diminished Ovarian Reserve Undergoing Fragile X Premutation Testing

About 10 % of infertile/subfertile women are diagnosed with diminished ovarian reserve (DOR), of which?<?5 % will become pregnant spontaneously. Fragile X (FMR1) genetic testing may provide a reason for her early ovarian aging and/or have reproductive implications. Seven women with DOR (genetic study subset) and the male partners of six of these women were separately interviewed about the experience of being asked to undergo this unanticipated genetic test. Three interviews were conducted (before, within 1 week after, and 3 months after learning the test results). None of the participants carried the FMR1 premutation (largest FMR1 allele 27–50 CGG repeats). For women, their pregnancy-seeking journey was long and exhausting. Women understood the reproductive implications of carrying the FMR1 premutation, and hoped for a negative result. Being offered a genetic test caused women to pause and re-think their future reproductive plans. Husbands viewed the infertility journey as filled with unknowns, of which the genetic test results would be one more puzzle piece. The expense of fertility testing/treatment was mentioned by both spouses, though more notably by husbands. The introduction of a possible genetic cause of infertility, with additional potential health consequences for future biological children, caused women to re-think their quest for pregnancy. In contrast, the genetic test was viewed as an additional source of information for their husbands as opposed to raising concern regarding potential reproductive ramifications.     

Perceived Risk Following Melanoma Genetic Testing: A 2-Year Prospective Study Distinguishing Subjective Estimates from Recall

A major goal of predictive genetic testing is to alert people to their risk before illness onset; however, little is known about how risk perceptions change following genetic testing and whether information is recalled accurately over time. In the United States, a CDKN2A/p16 mutation confers 76 % lifetime risk of melanoma. Following genetic counseling and test reporting, subjective risk estimates and recall of counselor-provided risk estimates were assessed 5 times over the next 2 years among 60 adult members of 2 extended CDKN2A/p16 kindreds. No sustained changes from baseline in risk perceptions were reported. Unaffected carriers (n?=?15) consistently reported significantly lower subjective risk estimates (46 %) than they were actually given (76 %, p?<?0.001) or recalled having been given (60 %, p?<?0.001). Noncarriers’ (n?=?27) risk estimates decreased following results disclosure, but rebounded, with both subjective and recalled estimates subsequently exceeding what they were told by the counselor (both ps?<?0.001). Affected carriers’ (n?=?18) risk estimates for developing a new melanoma corresponded well to counselor-provided information (p?=?0.362). For all 3 patient groups, results were consistent across multiple risk measures and remained similar when demographic, phenotypic, and baseline behavioral contributors to melanoma risk were statistically controlled. These findings are consistent with other studies of risk perception, but additional studies of more diverse populations are needed to understand the reasons behind both the persistence of initial risk estimates and their divergence from information provided by the counselor during genetic counseling. Additionally, determining whether holding subjective risk perceptions that differ from counselor-provided information ultimately affects adherence to management recommendations will help guide the presentation of risk information in genetic counseling practice.     

On the importance of being first: Serial order effects in the interaction between action plans and ongoing actions

When we plan sequences of actions, we must hold some elements of the sequence in working memory (WM) while we execute others. Research shows that execution of an action can be delayed if it partly overlaps (vs. does not overlap) with another action plan maintained in WM (partial repetition cost). However, it is not known whether all features of the action maintained in WM interfere equally with current actions. Most serial models of memory and action assume that interference will be equal, because all action features in the sequence should be activated to an equal degree in parallel; others assume that action features earlier in the sequence will interfere more than those later in the sequence, because earlier features will be more active. Using a partial repetition paradigm, this study examined whether serial position of action features in action sequences maintained in WM have an influence on current actions. Two stimulus events occurred in a sequence, and participants planned and maintained an action sequence to the first event (action A) in WM while executing a speeded response to the second event (action B). Results showed delayed execution of action B when it matched the first feature in the action A sequence (partial repetition cost), but not when it matched the last feature. These findings suggest that serial order is represented in the action plan prior to response execution, consistent with models that assume that serial order is represented by a primacy gradient of parallel feature activation prior to action execution.     

Interference due to shared features between action plans is influenced by working memory span

In this study, we examined the interactions between the action plans that we hold in memory and the actions that we carry out, asking whether the interference due to shared features between action plans is due to selection demands imposed on working memory. Individuals with low and high working memory spans learned arbitrary motor actions in response to two different visual events (A and B), presented in a serial order. They planned a response to the first event (A) and while maintaining this action plan in memory they then executed a speeded response to the second event (B). Afterward, they executed the action plan for the first event (A) maintained in memory. Speeded responses to the second event (B) were delayed when it shared an action feature (feature overlap) with the first event (A), relative to when it did not (no feature overlap). The size of the feature-overlap delay was greater for low-span than for high-span participants. This indicates that interference due to overlapping action plans is greater when fewer working memory resources are available, suggesting that this interference is due to selection demands imposed on working memory. Thus, working memory plays an important role in managing current and upcoming action plans, at least for newly learned tasks. Also, managing multiple action plans is compromised in individuals who have low versus high working memory spans.     

You’re Better Respected When You Carry Yourself as a Man: Black Men’s Personal Accounts of the Down Low “lifestyle”

Although the notion of a down low life style, called various things at various times, has a long history in the black community, the past few years have been marked by an exponential increase in attention of this phenomenon in both the mainstream press and scholarly work. However, much of this work has focused on exploring whether men on the down low present a unique threat for HIV infection to black women. Currently, there exist very few scholarly works exploring the lives of black men who have sex with men and women that specifically address their own experiences living on the down low or how these men personally define what it means to be on the down low. In this article, we explore why black men who have sex with men and black men who have sex with men and women, including those who self-identify as gay, bisexual or as being on the down low, come to use the down low label and what it means to them to be on the down low.