Patient Perspectives on Medical Trauma Related to Inflammatory Bowel Disease

Journal of Clinical Psychology in Medical Settings - Post-traumatic stress symptoms (PTSS) in response to medical trauma are understudied in inflammatory bowel disease (IBD). Two studies identify...     

The patient experience of medically unexplained symptoms: an existentialist analysis

This article explores the patient experience of medically unexplained symptoms (MUS) from an existentialist standpoint. Drawing on the work of Jean-Paul Sartre and Simone de Beauvoir, I explore their concepts of existential situation, existential project, authenticity, and praxis. I then analyze the situation of MUS patients in the current cultural and institutional context, elucidating that a lack of explanation for their symptoms puts MUS patients in an existential bind. I illustrate the effects of the experience of MUS on patients’ existential projects. Last, I develop an ethical response in the existentialist tradition from the perspective of patients, providers, and society at large. I argue that there is a collective responsibility to foster conditions more conducive to authentic patient well-being and to improve the experience of patients with medically unexplained symptoms.

     

The Sexual Self-Perceptions of Young Women Experiencing Abuse in Dating Relationships

Though information about one's sexuality may be inferred from sexual interactions themselves, a sexual sense of self may also be derived from the quality of the intimate relationship more generally. In this study, we examined the sexual self-perceptions of young women in dating relationships (N=108) as a function of whether these relationships were characterized by abuse. Negative sexual self-perceptions were found to be more evident among women who were experiencing physical/psychological abuse or sexual coercion in their current relationships than among women who were not, even after controlling for self-esteem and depressive symptoms. However, positive sexual self-perceptions were unaffected by abuse, and hence may provide young women a basis for establishing healthier relationships in future.     

Predicting whether multiculturalism positively or negatively influences White Americans' intergroup attitudes: the role of ethnic identification

Multiculturalism, or the belief that racial and ethnic differences should be acknowledged and appreciated, has been met with both positive reactions (e.g., decreased prejudice) and negative reactions (e.g., perceptions of threat) from dominant group members. The present research proposes that multiculturalism can either positively or negatively influence White Americans' intergroup attitudes depending on their degree of ethnic identification. In Studies 1 and 2, White Americans primed with multiculturalism exhibited higher social dominance orientation (Study 1) and greater prejudice (Study 2), especially when they identified strongly with their ethnicity. In Study 3, perceptions of threat to group values were found to mediate the relation between multiculturalism, ethnic identification, and prejudice among White Americans. The results are discussed in terms of their implications for threat perceptions, ethnic identification, and conceptions of diversity.     

The Application of Behavior Change Theory to Family-Based Services: Improving Parent Empowerment in Children’s Mental Health

We describe the development of a parent empowerment program (PEP) using a community-based participatory research approach. In collaboration with a group of dedicated family advocates working with the Mental Health Association of New York City and state policy makers, academic researchers took an iterative approach to crafting and refining PEP to better prepare family advocates to help bridge the gaps in service access among children with emotional and behavioral problems. Despite the growth of family-led, family support programs nationally, research that demonstrates the positive benefits of such programs is scarce in the children’s mental health literature. The PEP model is based on research data about barriers families face in mental health service utilization (e.g., stigma, perceptions of providers, attitudes towards mental illness, service availability, etc.). PEP is premised on (a) the concept of empowerment as a process, (b) the need to engage parents in becoming active agents of change, and (c) the application of an integrated framework to empower parents, called the Parents as Agents of Change model. Our paper focuses on describing the application of a Unified Theory of Behavior Change as a theoretical framework to help activate parents as change agents in meeting their children’s mental health needs. Based on an integrated model of grassroots driven Principles of Parent Support and research-based Unified Theory of Behavior Change, PEP’s Parents as Agents of Change model provides a conceptual framework for testing the effectiveness of family support services in children’s mental health, a much-needed area for future research.     

Initial Validation of the Children’s Worry Management Scale

We investigated the psychometric properties of a new instrument, the Children’s Worry Management Scale (CWMS). The CWMS has three subscales that specify methods of regulating worry: inhibition (the suppression of worry), dysregulation (exaggerated displays of worry), and coping (constructive ways of managing worry). Using a Caucasian, middle-class sample of 214 children (M = 9 years, 1 month), Study 1 provides reliability and validity data through patterns of correlations to parent- and child-completed measures of emotion management and behavioral problems. Internal consistencies range from .69 to .74. Study 2 establishes discriminant validity by demonstrating that the CWMS Dysregulation and Coping subscales differentiated, in the expected directions, between a group of children (n = 27) with DSM-IV anxiety diagnoses and a control group of children with no psychological disorders.     

Decomposing identity: differential relationships between several aspects of ethnic identity and the negative effects of perceived discrimination among First Nations adults in Canada

The present investigation examined the relationship between perceived discrimination and depressive symptoms among First Nations adults in Canada (N = 220). It was considered that specific aspects of ethnic identity (in-group affect, centrality, in-group ties) could serve as resilience and/or vulnerability factors. Whereas in-group affect (positive feelings regarding one's group) was directly associated with decreased depressive symptoms and buffered against perceived discrimination, high levels of centrality (salience of group membership) was associated with increased symptomatology and intensified the relation between perceived discrimination and depressive symptoms. In-group ties (connection to other group members) buffered against perceived discrimination, although this protective effect only applied for males. The data underscore the importance of examining different aspects of identity and gender differences in determining the role of ethnic identity in the well-being of minority populations.     

Family Support in Children’s Mental Health: A Review and Synthesis

A comprehensive review of structured family support programs in children’s mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met criteria for inclusion. Programs were categorized by whether they were delivered by peer family members, clinicians, or teams. Five salient components of family support were identified: (a) informational, (b) instructional, (c) emotional, (d) instrumental, and (e) advocacy. Clinician-led programs were heavily represented (n = 33, 66%), followed by family-led (n = 11, 22%), and team-delivered (n = 6, 12%) programs. Key differences between programs delivered by clinicians or by peer family members were found in the degree of emphasis, research methodology, and outcomes. However, the content of the components was similar across all three program types. There are both important differences in emphasis across typologies of family support provided by clinicians, family members, or teams as well as important similarities in content. Family-delivered support may be an important adjunct to existing services for parents, although the research base remains thin. A research agenda to promote more rigorous evaluations of these services especially those delivered by peer family members is critical.     

Internet-delivered physical activity intervention for college students with mental health disorders: a randomized pilot trial

The prevalence of mental health disorders among college students is rising and the increasing rates of anxiety and depression have important societal implications. Physical activity has been proposed as an adjuvant to traditional treatment approaches (i.e. psychotherapy or pharmacotherapy), and the internet is a potentially useful means of delivering physical activity information to the college-aged population. This randomized pilot trial examined the effects of an internet-based physical activity intervention on physical activity, self-efficacy, depression, and anxiety in college students (n?=?47) receiving mental health counseling. Physical activity, depression, anxiety, exercise self-efficacy, and barriers self-efficacy were assessed at baseline and post-intervention. There was a significant time effect for physical activity, with both groups increasing their physical activity levels across the 10-week intervention but with a larger increase in the intervention condition (d?=?0.68) than the control condition (d?=?0.05). Exercise and barriers self-efficacy declined across the intervention, but more so in the control than intervention condition. Effects on depression and anxiety were nonsignificant. Finally, correlation analyses showed increases in physical activity were associated with increases in exercise self-efficacy (r?=?0.62) and barriers self-efficacy (r?=?0.63) and decreases in depression (r?=?-0.44) in the intervention condition, but not in the control condition. These results suggest that an internet-delivered physical activity intervention may be a promising approach to promoting physical activity among college students undergoing mental health counseling.