Applied ethics in mental health in Cuba: part II--power differentials,dilemmas, resources,and limitations

This article is the second one in a series dealing with mental health ethics in Cuba. It reports on ethical dilemmas, resources and limitations to their resolution, and recommendations for action. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans experience dilemmas related to (a) the interests of clients, (b) their personal interests, and (c) the interests of the state. These conflicts are related to power differentials among (a) clients and professionals, (b) professionals from different disciplines, and (c) professionals and organizational authorities. Resources to solve ethical dilemmas include government support, ethics committees, and collegial dialogue. Limitations include minimal training in ethics, lack of safe space to discuss professional disagreements, and little tolerance for criticism. Recommendations to address ethical dilemmas include better training, implementation of a code of ethics, and provision of safe space to discuss ethical dilemmas. The findings are discussed in light of the role of power in applied ethics.     

Applied ethics in mental health in Cuba: part I--guiding concepts and values

As part of a project on professionals' lived experience of ethics, this article explores the guiding concepts and values concerning ethics of mental health professionals in Cuba. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans conceptualize applied ethics in terms of its central role in professional practice and its connection to the social context and subjective processes. Findings also show that Cuban professionals are guided not only by a set of professional values but by a set of civic values as well. The former are subdivided into other-oriented values and self-oriented values. The study of ethics in another culture such as Cuba offers a unique point of view from which to critique the social construction of our own conceptions of applied ethics in North America.     

Psychological distress with relationship satisfaction is moderated by anticipatory relational savoring among non-deployed military partners

This study recruited participants whose partners were deployed for active-duty military service to examine whether anticipatory relational savoring moderated the association of psychological distress with relationship satisfaction. Two weeks prior to their partner's deployment (T1), participants (N = 73) completed a self-report measure of relationship satisfaction. Then, 2 weeks into their partner's deployment (T2), participants completed self-report measures of stress, loneliness, and depression (combined into a composite index of psychological distress), and relationship satisfaction. Participants also completed a stream-of-consciousness task at T2 in which they imagined and discussed their partner's return from deployment. We coded the stream-of-consciousness task for anticipatory relational savoring regarding their upcoming reunion with their deployed partner. We found that anticipatory relational savoring moderated the association of psychological distress with during-deployment relationship satisfaction after adjusting for demographics, interpersonal variables, and deployment-specific variables; the association did not hold after adjusting for pre-deployment relationship satisfaction, and thus was robust when considering the distress-satisfaction association during the deployment but was not when considering changes in relationship satisfaction from pre- to during-deployment. We discuss the potential importance of anticipatory relational savoring for this unique population.     

Clinical applications of Matte Blanco's thinking

Ignacio Matte Blanco (1908–1995) left very few specific indications about the applications of his theoretical notions to his interpretative style. The author shows how he uses Matte Blanco to formulate some of his own interpretations. The first part of the paper uses clinical vignettes to illustrate some of Matte‐Blanco's concepts. Their theoretical vocabulary is thus made explicit. Then two psychoanalytic sessions are discussed at greater length, together with one from a therapy, so that the use of Matte‐Blanco's notions can be seen clearly, allowing for a fresh perspective on areas of psychoanalytic theory, particularly dreams, psychopathology viewed according to the proportions of asymmetrical and symmetrical functioning in the patient's bi‐logical mental system, the multidimensionality of the unconscious, the structural unconscious, the emotion‐thought relationship, projective identification, resistance, and negative therapeutic reaction. The practical consequences of all this are elaborated, particularly the ensuing possibility of ‘thinking with the patient' in the session. This enables the patient to introject a form of mental functioning in which the asymmetrical mode is not invaded by the symmetric mode (a parallel can be seen here with the Bionian concept of dialogue between the psychotic and non‐psychotic parts of the mind).     

Heterosexual Men’s Confrontation of Sexual Prejudice: The Role of Precarious Manhood

Prejudice and discrimination are unfortunate common realities for sexual minorities yet people rarely confront such behavior (Dickter 2012). This is especially problematic because confronting prejudice is one of the most effective weapons against it (e.g., Czopp and Monteith 2003). The present study explores whether men who perceive manhood to be an impermanent state easily taken away by engaging in gender role violations (i.e., precarious manhood; Vandello et al. 2008) are less likely to react negatively to sexually prejudiced interaction partners and therefore less likely to confront sexual prejudice. In addition, we tested whether non-confrontation serves to affirm meta-perceptions of heterosexuality. To test this hypothesis, 88 heterosexual, young adult males, drawn from the undergraduate population of a university in the northeastern U.S., were randomly assigned to either pair with a confederate who expressed blatant sexual prejudice or no blatant prejudice toward a gay applicant in a hiring discussion. Consistent with predictions, precarious manhood predicted lower rates of confronting sexual prejudice, and less negative responses to their interaction partner, while confronting prejudice was associated with believing one would be viewed as gay regardless of individual differences in precarious manhood.     

Can reading time predict mind wandering in expository text?

Prior research has suggested that episodes of mind wandering not only negatively impact text comprehension but also are associated with fluctuations in reading behavior. However, these studies typically do not account for differences in the fundamental nature of the text itself, namely, whether it is narrative or expository in structure. As much research has supported the idea that these text genres are processed differently, it is of interest to determine whether similar changes in reading patterns are observed when mind wandering in an expository text. The present study examined whether fluctuations in sentence‐by‐sentence reading times were associated with periods of mindless reading during processing of an expository text. Results indicated that although mindless reading did negatively impact learning, probed reading time did not vary as a function of mind wandering. These results suggest that research aimed at studying mind wandering while reading may need to account for text genre.     

The psychology of being a beginner

Beginners are plagued with overconfidence. They perform the worst on tests of knowledge or skill and yet are the most overconfident. One would expect that learning would better calibrate beginners and lead to better quality decisions. However, learning can instead produce overconfidence. In this article I discuss how being beginner can lead to errors in self-assessments and riskier decisions. I review differences in beginner overconfidence in several places in the literature. First, the Dunning–Kruger Effect, which finds those with the least knowledge are the most overconfident. To be sure, beginners can range from rank beginners, those who have acquired no knowledge, to experienced beginners, beginners who having gained some but not vast knowledge. Next, I discuss the beginner's bubble that follows the trajectory of confidence and overconfidence as people transition from rank to experienced beginners. The beginner's bubble pattern finds rank beginners have insight into their poor abilities. However, with some learning there is a surge of confidence and overconfidence. Lastly, I explore differences in confidence and overconfidence as learners transition from rank to experienced beginners in other places in the literature.     

Developing a Culturally Appropriate Depression Prevention Program: Opportunities and Challenges

This paper describes the experiences of the first author and his colleagues in the development and implementation of a depression prevention program that specifically targets Latina mothers. Building on the earlier papers that highlight the underutilization of mental health services by Latinos in general, this paper will make the case that the situation is particularly concerning with regards to depression. In addition to the fact that depression is a highly prevalent disorder among Latino adults, the potential consequences for children of parents with depression are significant. Thus, the underutilization of formal mental health services by Latinos makes depression a critical public health problem that calls for creative solutions. One possible solution is the careful development and implementation of prevention programs. Depression prevention programs have some advantages over formal mental health treatment in that they can be offered at a relatively low cost, can be packaged in ways that make them less stigmatizing, and if effective, can reduce the incidence of cases that develop into clinical depression.This paper will describe the process of developing a novel depression prevention program, with a particular focus on the attention paid to cultural sensitivity. We describe the complexity inherent in defining cultural sensitivity and illustrate in concrete ways its implementation in the development and evaluation of the prevention program. In addition, we explore some of the challenges that emerge when attempting to balance the creation of a program that is culturally sensitive with the demands of rigorous quantitative evaluation.