Cultural Lens on Mental Illness: Four Clients Share Their Perspectives

People served by mental health providers represent diverse cultural groups. In-depth qualitative interviews were used to collect data to examine: “How do people, diagnosed with a mental illness, perceive their experience in a partial care mental health program from the perspective of their cultural context?” Four participants described cultural identities that included ethnic, health status, and sexual orientation identities. The participants' way of participating in the world was often in conflict with cultural values and expectations of the family and counselors. Cultural competence must include understanding how complex, multiple cultural contexts interact and influence a person's participation in the therapeutic process.     

Balancing Act: Career and Family During College-Educated Women’s 30s

We assessed career, marriage, and motherhood expectations of 118 White Women and 82 Women of Color in 1993, when they were seniors at five northeastern U.S. colleges. Sixteen years later, in 2009, 77.5 % responded to our survey and answered questions about their career, marriage, motherhood, attitudes, and life satisfaction outcomes. As seniors, they wanted it all, career, marriage, and motherhood. In 2009, nearly two thirds were employed full time, 91 % had married, nearly three quarters were mothers, and about 57 % were combining full-time employment and motherhood. Comparisons are made among three role-status outcome groups: Have It All (mothers, employed full time); Traditional (mothers, employed part time or not at all), and Employed Only (childfree, employed full time). Educational level of the women did not predict role status. Spouses’ educational level relative to the women’s predicted role status, with Have It All women more likely to be married to less educated spouses than Traditional or Employed Only women. The role-status groups did not differ in their attitudes toward women in general, but Have It All mothers had lower levels of employment-related concerns about separation from their children than Traditional mothers. Most of the women still wanted to have it all. Many Traditional women looked forward to returning to employment, and many of the Employed Only women wanted to have children. Being a mother was associated with higher life satisfaction than being childfree. Results are discussed in terms of multiple-role theory and the positive influence of having family roles in the mix.     

The Analyst's Participation in the Process

Using a clinical vignette, in which self-disclosure appears as a starting point, the authors investigate the connection between method and techniques. As the recent literature on the subject generally maintains, the classical analysts' neutral position can no longer be accepted. Analysts are always fully engaged in the intersubjective relationship and pass their values on to their patients through their professional roles - which can be understood as self-disclosure in a wider meaning. However, self-disclosure, and in more general terms the analyst's participation in the process, need technical criteria of reference. By deepening the relationship between method and techniques, established by Rapaport, the authors maintain that method is determined by theory and in turn gives meaning to techniques. As a consequence, techniques play a minor role with regard to theory and method. The opening of psychoanalysis to the relational perspective is bringing about the decrease of technique as an absolute value in favour of a greater self-awareness of the analyst who, following the method related to his/her theory will be able to better cope with techniques.     

The Failure to Contain: How Persecutory Anxieties Contribute to Noncompliance in Adult Patients with Congenital Chronic Pain Conditions

ABSTRACT

Patients with sickle-cell disease suffer from lifelong pain. Many prefer to receive emergent rather than managed health care, which results in these people being termed “noncompliant.” This paper explores the contributing factors of such noncompliance in the adult patient with painful chronic illness. In the earliest stages of development, internal pain is attributed to external origins, and the effects of this on the psyche are analogous to those of physical abuse. When the infant's pain cannot be contained, projective identification and persecutory anxieties become deeply ingrained. Interventions that focus on healing from trauma and building trust are preferable to those which most value immediate compliance, as the patterns of behavior are so firmly entrenched.     

Stability and Change of Ego Resiliency From Late Adolescence to Young Adulthood: A Multiperspective Study Using the ER89–R Scale

In this research, we examined the psychometric properties of the Revised Ego Resiliency 89 Scale (ER89–R; Alessandri, Vecchio, Steca, Caprara, & Caprara, 2008), a brief self-report measure of ego resiliency. The scale has been used to assess the development of ego resiliency from late adolescence to emerging adulthood, focusing on different ways to define continuity and change. We analyzed longitudinal self-report data from 267 late adolescents (44% male) using 4 different approaches: factor analysis for testing construct continuity, correlational analysis for examining differential stability, latent growth modeling for analyzing mean level change, and the reliable change index for studying the occurrence of change at the individual level. Converging evidence points to the marked stability of ego resiliency from 16 to 20 years, both for males and females. The scale predicts externalizing and internalizing problems, both concurrently and at 2 and 4 years of distance. Findings suggest that the ER89–R scale represents a valid and reliable instrument that can be fruitfully suited for studying ego resiliency through various developmental stages.     

Using Latent Class Analysis to Model Temperament Types

Mixture models are appropriate for data that arise from a set of qualitatively different subpopulations. In this study, latent class analysis was applied to observational data from a laboratory assessment of infant temperament at four months of age. The EM algorithm was used to fit the models, and the Bayesian method of posterior predictive checks was used for model selection. Results show at least three types of infant temperament, with patterns consistent with those identified by previous researchers who classified the infants using a theoretically based system. Multiple imputation of group memberships is proposed as an alternative to assigning subjects to the latent class with maximum posterior probability in order to reflect variance due to uncertainty in the parameter estimation. Latent class membership at four months of age predicted longitudinal outcomes at four years of age. The example illustrates issues relevant to all mixture models, including estimation, multi-modality, model selection, and comparisons based on the latent group indicators.     

Same kinematics but different objects during action observation: Detection times and motor evoked potentials

Motor resonance refers to the fact that an observed action is online subliminally reenacted. The aim of the present paper was to verify if, on equal terms of kinematics, the to-be-grasped object's intrinsic properties are influencing the observers' motor behaviour. A detection time and a single pulse transcranial magnetic stimulation experiment were performed to verify the effects of a change of object's intrinsic properties artificially made on a video showing a grasping action. In particular, the object substituting the original one was not graspable by the showed movement. Results indicated an influence of object's intrinsic properties: Detection times were delayed and motor evoked potentials were reduced when the movement shown was not suitable to grasp the object. These results are interpreted as an evidence that during grasping action observation the motor system of the observer is influenced not only by the seen movements but also by the to-be-grasped object.     

Effects of achievement motivation, social identity, and peer group norms on academic conformity

This study investigated whether academic achievement motivation and social identity explain variation in children’s conformity to positive academic behaviors (n = 455 children in grades three through five). Structural equation modeling suggested that academic value and peer group academic norms were positively related to academic conformity. Specifically, children who enjoyed academic pursuits and who belonged to academically-inclined peer groups were more likely to conform to novel academic behaviors than children who did not. Additionally, academic value moderated the relationship between peer group norms and conformity, implying that, for students who do not value academics, belonging to a peer group with high academic norms will lead to more conformity to academic behaviors than belonging to a peer group with low academic norms. In contrast, analyses suggested that some aspects of achievement motivation and social identity are unrelated to academic conformity. Implications for encouraging positive academic behaviors in middle childhood are discussed.     

Are all letters really processed equally and in parallel? Further evidence of a robust first letter advantage

This present study examined accuracy and response latency of letter processing as a function of position within a horizontal array. In a series of 4 Experiments, target-strings were briefly (33 ms for Experiments 1 to 3, 83 ms for Experiment 4) displayed and both forward and backward masked. Participants then made a two alternative forced choice. The two alternative responses differed just in one element of the string, and position of mismatch was systematically manipulated. In Experiment 1, words of different lengths (from 3 to 6 letters) were presented in separate blocks. Across different lengths, there was a robust advantage in performance when the alternative response was different for the letter occurring at the first position, compared to when the difference occurred at any other position. Experiment 2 replicated this finding with the same materials used in Experiment 1, but with words of different lengths randomly intermixed within blocks. Experiment 3 provided evidence of the first position advantage with legal nonwords and strings of consonants, but did not provide any first position advantage for non-alphabetic symbols. The lack of a first position advantage for symbols was replicated in Experiment 4, where target-strings were displayed for a longer duration (83 ms). Taken together these results suggest that the first position advantage is a phenomenon that occurs specifically and selectively for letters, independent of lexical constraints. We argue that the results are consistent with models that assume a processing advantage for coding letters in the first position, and are inconsistent with the commonly held assumption in visual word recognition models that letters are equally processed in parallel independent of letter position.