Life Meaning Following Combat Among Air Force Security Forces Personnel

An active duty Air Force ground combat unit (n = 189) completed surveys about trauma and combat exposure, mood symptoms, and meaning in life. Two dimensions of deployment-related traumas were assessed: combat (e.g., firing weapons, being fired upon) and aftermath (e.g., seeing dead bodies, injury). Results of regression analyses indicated that Airmen who experienced more intense combat reported less presence of meaning in life, although the significant interaction with gender suggested declines in meaning in life were especially pronounced among males with higher combat intensity. In contrast, more intense aftermath exposure was associated with slightly stronger meaning in life, with no differences by gender. Intensity of combat exposure might differentially affect perceived meaning in life for male versus female combatants.     

Small Unit Leader Perceptions of Managing Soldier Behavioral Health and Associated Factors

This investigation explored squad leaders’ perceptions of their roles managing subordinate soldiers’ behavioral health (BH) needs. The data were obtained through an anonymous survey of 458 squad leaders (i.e., small unit leaders who oversee 4–10 soldiers). More than 80% of squad leaders perceived management of soldier BH needs before, during, and after treatment as their responsibility, and felt comfortable and capable of executing these roles. Latent class analysis was used to determine groups of “most active,” “moderately active,” and “least active” leaders. Multinomial logistic regression was used to compare the least and most active classes. The most active leaders were more likely to report high BH knowledge, dedication to a common purpose, and low levels of “associative” stigma. These results should inform leader management of soldier BH. Future research should examine active leader characteristics and whether evidence-based training can increase support for preventing and managing BH issues.     

Memory Outcome After Pediatric Epilepsy Surgery: Objective and Subjective Perspectives

Memory was investigated in 27 children and adolescents in a longitudinal study before and at one and two years after epilepsy surgery. A comparison group with intractable epilepsy (n = 15), matched in age, sex, age of seizure onset, and IQ, was studied at comparable points in time. Methods included administration of standardized measures of story recall and face recognition, and qualitative interviews to probe the participants’ perceptions of their memory function over time. There was no significant change over time in either group on the standardized measures. Site and laterality of excision, age at surgery, and seizure outcome were not predictive of change within the surgical group. The narratives revealed facets of memory that were problematic in daily life. The objective and subjective results showed low concordance regarding change, possibly due to limitations in the objective measures for capturing semantic and autobiographical memory.     

A broken relationship

These words were written at the conclusion of my Jungian analysis. As I wrote, I did not know the doctor's unexplained absence was due to an illness which would cause his death. Truly, the light that once glowed between us did not glow again.     

To know or not to know: an application of Bion’s K and –K to child treatment1

The authors discuss an application of Bion’s conceptualisation of thinking and non-thinking states (K and –K links) to the treatment of a nine-year-old girl. The authors consider Bion’s interrelated concepts such as K and –K, container/contained, maternal reverie, and the development of thinking through alpha function to be highly applicable to child treatment. The afore-mentioned conceptual elements are used to elucidate case material over two consecutive hours. A K link is established between therapist and patient, the fragility of which link is then demonstrated by its deterioration into a –K link. Complex issues about knowing and not knowing are central in this girl’s clinical presentation. She was conceived through in vitro fertilisation (IVF), and subsequently diagnosed with cerebral palsy. The authors consider the emotional impact of this origin story and how the parents relate to it. The authors discuss how parents sometimes cope with perceived losses by wishing to shield or protect their children. This can have repercussions for children’s efforts to know (K) and not to know (?K). The fear that emotional knowledge will be too painful to bear can interfere with ‘learning from experience’. Bion’s premise that the purpose of analysis is the growth of the mind is synonymous with the child analyst’s goal of fostering development and understanding impediments to development.     

Women Inmate Substance Abusers’ Reactivity to Visual Alcohol, Cigarette, Marijuana, and Crack-Cocaine Cues: Approach and Avoidance as Separate Dimensions of Reactivity

Despite the growing recognition for multidimensional assessments of cue-elicited craving, few studies have attempted to measure multiple response domains associated with craving. The present study evaluated the Ambivalence Model of Craving (Breiner et al. Alcohol Research and Health 23:197–206, 1999; Stritzke et al. 2007) using a unique cue reactivity methodology designed to capture both the desire to use (approach inclination) and desire to not consume (avoidance inclination) in a clinical sample of incarcerated female substance abusers. Participants were 155 incarcerated women who were participating in or waiting to begin participation in a nine-month drug treatment program. Results indicated that all four substance cue-types (alcohol, cigarette, marijuana, and crack cocaine) had good reliability and showed high specificity. Also, the validity of measuring approach and avoidance as separate dimensions was supported, as demonstrated by meaningful clinical distinctions between groups evincing different reactivity patterns and incremental prediction of avoidance inclinations on measures of stages of change readiness. Taken together, results continue to highlight the importance of measuring both approach and avoidance inclinations in the study of cue-elicited craving.     

Training in health psychology: An international look

With the progression of health psychology as a new field in psychology specific training programs are more and more needed. A survey of the training situation of health psychology in Northern America, Europe, Australia, and New Zealand highlighted a lack of formalized training programs in most countries except the United States and Canada, as well as an enormous variety between countries on standards of training, and on the differentiation of health psychologists from clinical psychologists.

For the qualification of health psychology as an independent psychological discipline a plea is made for international standardization of quality control and suggestions for the content of formalized training programs in health psychology are given.     

Personal mastery predicts pain,stress, fatigue,and blood pressure in adults with rheumatoid arthritis

Among individuals with rheumatoid arthritis (RA), stress-associated disease flare can severely impact well-being. Psychological factors such as personal mastery may buffer an individual from the negative effects of those flares. We tested the hypothesis that a high sense of personal mastery would prospectively predict stress reactivity. Measures of pain, perceived stress, fatigue, and mean arterial pressure (MAP) were collected before, during, and after two interpersonal stressors conducted on 73 individuals with RA. Factor analysis of the personal mastery scale yielded two independent factors: a 5-item “fatalism” component and a 2-item “control” component. Individuals with high fatalism scores reported overall greater joint pain at baseline and those scoring high on control exhibited lower MAP, and reported less stress and fatigue at baseline. After controlling for baseline differences, those high in control exhibited greater MAP increase during stress, and less drop in pain when compared to those low in control. These results suggest that individuals high in control may be more susceptible to the effects of acute stress; however, the overall beneficial aspects of high control outweigh the acute negative effects. Personal mastery may play a role in the experience of pain, stress, and fatigue for people with RA.