Unique pathways to resilience across cultures

An international mixed methods study of resilience of 14 sites in eleven countries identified seven tensions that youth resolve in culturally specific ways. Resolution of these tensions is foundational to experiences of resilience. This paper reports on the qualitative findings from interviews with 89 youth. Results support a culturally embedded understanding of positive youth development that better accounts for young people's resilience in western and non-western countries. Specifically, the seven tensions identified include: access to material resources, relationships, identity, cohesion, power and control, social justice, and cultural adherence. Findings show that no one pattern in the resolution of these tensions predicts resilience better than another. A case study of a Palestinian boy demonstrates the intersection of the seven tensions and the uniqueness of their resolution. The implications of this work for interventions is discussed.     

Cutting stress off at the pass: reducing vigilance and responsiveness to social threat by manipulating attention

Personality processes relating to social perception have been shown to play a significant role in the experience of stress. In 5 studies, the authors demonstrate that early stage attentional processes influence the perception of social threat and modify the human stress response. The authors first show that cortisol release in response to a stressful situation correlates with selective attention toward social threat. Second, the authors show in 2 laboratory studies that this attentional pattern, most evident among individuals with low self-esteem, can be modified with a repetitive training task. Next, in a field study, students trained to modify their attentional pattern to reduce vigilance for social threat showed lower self-reported stress related to their final exam. In a final field study with telemarketers, the attentional training task led to increased self-esteem, decreased cortisol and perceived stress responses, higher confidence, and greater work performance. Taken together, these results demonstrate the impact of antecedent-focused strategies on the late-stage consequences of social stress.     

Night waking in 6-month-old infants and maternal depressive symptoms

Relations between night waking in infants and depressive symptoms in their mothers at 6 months postpartum were examined using the data from the National Institute for Child Health and Human Development Study of Early Child Care. Although more depressive symptoms were only weakly correlated with a higher frequency of infant waking, longer wake times, and more total time awake, the rate of clinically significant depression scores was about double in mothers of chronically waking infants in comparison with mothers whose infants did not awaken during the night. The value of comparing subgroups to elucidate relations identified through correlations is discussed.     

Gender differences in the family-relatedness of relocation decisions

Using a dyadic study design, the present study draws on research into the family-relatedness of work decisions to examine the impact of the spouse's characteristics on an employee's willingness to engage in job-related relocation. With a sample of 1234 employees, the results show that spousal willingness to relocate mediates (a) the negative effect of the spouse's community ties and (b) the positive effect of the spouse's job alternatives on an employee's willingness to relocate. The indirect effect of the spouse's job alternatives was stronger among female than among male employees. To validate employees' perceptions, this study uses matched data from a subsample of 207 employees and their spouses to test a multi-source model, which revealed several notable inconsistencies. Our exploration of discrepancies between employee and spousal ratings helps explain these differences between single-source and multi-source models. Overall, findings suggest that employees consider various spousal factors in their career decision-making, and the family-relatedness of relocation decisions is particularly strong among female employees.     

Experiences of Women Who Underwent Predictive BRCA 1/2 Mutation Testing Before the Age of 30

This qualitative interview study focuses on the experiences of a sample of British female BRCA 1/2 carriers who had predictive testing before the age of 30, which is the minimum age for breast screening in the UK. Following appropriate informed consent procedures participants were recruited through the Cancer Genetics Service for Wales. Semi-structured interviews were conducted face-to-face with seven participants, transcribed in full and analyzed using thematic analysis. The motives for testing and perceived advantages described by participants were similar to those identified in previous studies with older participants, such as increased awareness and knowledge and feeling more in control. However some of the perceived disadvantages were specific to younger women, including feeling pressured to make important life decisions earlier than they would have liked, such as about family planning and risk reducing surgery. Participants also reported feeling abandoned or forgotten because of lack of ongoing clinical contact, or feeling “stuck waiting” for screening to begin. However, none felt that these disadvantages were a reason to regret having testing. Findings in this small study suggest that having BRCA 1/2 predictive testing can have positive outcomes for young women even though they may be unable to access interventions such as breast screening. However it may be helpful to encourage young women during pre-test counseling to explore the decisions and choices they may face. These young women could benefit from ongoing support and follow up and increased interaction with healthcare professionals.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.