Willingness to Seek Treatment Among Black Students With Anxiety or Depression: The Synergistic Effect of Sociocultural Factors With Symptom Severity and Intolerance of Uncertainty

Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust–interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students.     

Salience Versus Proportional Reasoning: Rethinking the Mechanism Behind Graphical Display Effects

Two experiments examined predictions from two separate explanations for previously observed display effects for communicating low‐probability risks: foreground:background salience and proportional reasoning. According to foreground:background salience, people's risk perceptions are based on the relative salience of the foreground (number of people harmed) versus the background (number of people at risk), such that calling attention to the background makes the risk seem smaller. Conversely, the proportional reasoning explanation states that what matters is whether the respondent attends to the proportion, which conveys how small the risk is. In Experiment 1, we made the background more salient via color and bolding; in contrast to the foreground:background salience prediction, this manipulation did not influence participants' risk aversion. In Experiment 2, we separately manipulated whether the foreground and the background were displayed graphically or numerically. In keeping with the proportional reasoning hypothesis, there was an interaction whereby participants given formats that displayed the foreground and background in the same modality (graphs or numbers, thereby making the proportion easier to form) saw the probability as smaller and were less risk averse than participants given the information in different modalities. There was also a main effect of displaying the background graphically, providing some support for foreground:background salience. In total, this work suggests that the proportional reasoning account provides a good explanation of many display effects related to communicating low‐probability risks, although there is some role for foreground:background salience as well. Copyright © 2018 John Wiley & Sons, Ltd.     

华西圣教书会的文字事工及其影响(1899-1919)

华西圣教书会于1899年初成立于重庆,存续40余年,于1941年关闭,是基督教在华西地区最重要的文字机构之一①.本文以清末民初为时限,考察华西圣教书会成立过程及其出版、发行状况,并分析基督教文字事业对华西社会变迁所起到的重大作用.     

关注肿瘤患者避免过度诊疗——解析ASCO大会关于肿瘤诊疗的5项建议

现代肿瘤的诊疗水平已经有了长足的进步,先进的诊断技术使得很多肿瘤得以早期发现并积极治疗,很多晚期患者也不再面临无药可用的境地,但由于临床医生的认识存在偏差,存在过度诊断和过度治疗的问题,进而给患者带来不必要的负担和痛苦。美国临床肿瘤学会（ASC0）年会上发布了一篇名为“ASCO为改善肿瘤治疗质量及医疗花费的5项建议”的文章,特别提出要重视五项临床广泛应用、花费较大,但缺乏高级临床证据的肿瘤治疗或干预措施,也提示我们需要充分评估,综合思考,为合适的患者提供正确的诊治方案,才能给患者带来更大的获益。     

Tales of Plagues and Carnivals: Samuel R. Delany, AIDS, and the Grammar of Dissent

While even today lesbian, gay, bisexual and transgender people might have cause to distrust the healthcare establishment, how much more fragile was the relationship between sexual minorities and health professionals in the first decade of the AIDS epidemic. Dissent from consensus healthcare and health research then was a question of survival in the face of political and medical intransigence. This article focuses on one version of AIDS dissent: The narrative representations of AIDS in fiction by the gay African-American fantasy writer Samuel R. Delany, which rejected the rigid binarism of “safe” and “unsafe” sex practices, Delany’s evidence-based dissent. He also engaged in a related form of cultural dissent: speaking the unspeakably obscene, at a time when Silence?=?Death. Delany called into question both the inferential leaps based on limited epidemiological research that were represented in safer sex guidelines and the widespread public reticence about sexual behavior.     

Functional foibles and the analysis of social change

Functional analysis is the major theoretical perspective of contemporary sociology. Although many fruitful studies of social structure have resulted from the application of this perspective, it has been notably sterile in coping with questions of social change. Two major shortcomings of the functionalist view of change are here examined. The first type of shortcoming might be called ‘evolutionary hangovers’. Under this heading we may include ‘functional ahistoricism’ and a ‘commitment to progress’. The second major shortcoming refers to weaknesses of functional theory per se — namely, a confusion of causal analysis with functional analysis, a lack of a theory of deviance, and an over‐emphasis on stable equilibrium models.