Assessing the Level of Structural Integration Using Operationalized Psychodynamic Diagnosis (OPD): Implications for DSM–5

In order to investigate the state-trait anxiety distinction in emotionally disturbed and normal children, the responses of 120 emotionally disturbed children and 126 normal children to the State-Trait Anxiety Inventory for Children (Spielberger, 1973) were factor analyzed separately. For the emotionally disturbed group two A-State and two A-Trait factors were found with the A-State factors accounting for significantly more of the variance than did A-Trait factors. For the normal group four A-State and two A-Trait factors were found, but there was not a significant difference between the amount of variance accounted for by A-State and A-Trait factors. Results were discussed as supporting the state-trait distinction and as having several implications for future research on anxiety.     

Association Between Socio-Ecological Risk Factor Clustering and Mental,Emotional, and Behavioral Problems in Hispanic Adolescents

Compared to non-Hispanic whites, Hispanic adolescents in the U.S. report higher rates of several mental, emotional, and behavioral problems such as substance use, sexual risk behaviors, and internalizing and externalizing problems. There is evidence of common pathways in the development of mental, emotional, and behavioral problems with certain subgroups of Hispanic adolescents being at greater risk. In the present article, we report analysis of baseline data for 959 Hispanic adolescents who participated in one of two randomized controlled trials evaluating a family-based preventive intervention. Utilizing latent class analysis, we identified subgroups of Hispanic adolescents based on socio-ecological risk and protective factors (e.g., parent–adolescent communication, parental involvement in school). Three distinct socio-ecological risk subgroups (high, medium, and low risk) were identified and exhibited significant differences from each other across a majority of socio-ecological risk and protective factors. Adolescents in higher socio-ecological risk subgroups reported greater mental, emotional, and behavioral problems across all outcomes. Individual comparisons revealed significant differences between the low socio-ecological risk group and both the medium and high socio-ecological risk group in lifetime alcohol use, smoking, and sex, as well as internalizing and externalizing problems. Implications for intervention include focusing on specific risk subgroups and targeting shared risk and protective factors rather than specific mental, emotional, and behavioral outcomes.     

MORAL INJURY*

The devastating effect on the self of moral injury, often a core component of trauma, occurring when one’s actions have profoundly violated one’s code of ethics, when one has been a victim of such violation, or when one has been a passive witness, has been extensively explored as it has occurred in veterans of the wars in Vietnam, Iraq and Afghanistan. Two examples illustrate its prevalence in civilian life. The literature shows violation of expected empathy from and for others, inherent in our nature, is more devastating than violation of the ethical code of our culture or sub-culture, adherence to which becomes urgent as our need emerges to belong to the culture or subculture of which we are a part, values which often contradict our innate sense of “what is right.”     

医学伦理学——欧洲与中国的桥

跨文化医学伦理学研究,要求我们以理智的方式去应对全球化。既要维护多样性,又要明确共同利益、亦要追求共同目标。任何文化都不能强行提出一些标准去规范国际间的生物医学。自主权应坚持义务论的解释,否则一个强势风气将会支配利益的选择解释,将文化多样性在伦理学中铸成一个统一的模式,形成自主权的“通货膨胀倾向”。     

The emergent father role

Using data collected before and after birth of a couple's first child, change in each parent's view of men as fathers was investigated in a short-term longitudinal study. Semantic differential scales tapped the man's image of self as father, the woman's image of husband as father, and each parent's rating of the baby's adjustment. Interview questions provided information on circumstances of the birth, the father's early child care activities, and parents' previous child care experience. Men's judgments of their own effectiveness as fathers declined from before the birth to afterward. Wives' judgments of their husbands' effectiveness as fathers also declined over that same period, but wives rated husbands higher than husbands rated themselves at both times. A single-equation multiple regression model, adapted from a structural model, was estimated to explain change in both spouses' ratings of the man's paternal role competence. It revealed that working-class spouses agreed on the basis for their judgments of the father's role performance, in that both judged him mainly in terms of how much he participated in child care. Middle-class spouses disagreed on the basis for their judgments of fathers, however. The middle-class men rated their own performance in the father role mainly in terms of the baby's adjustment; if they judged the baby to be happier, they judged themselves to be more competent as fathers. The middle-class women did not rate fathers on that basis. Instead, the middle-class women's ratings responded to the circumstances of the birth and to the father's participation in child care chores. Findings are discussed in terms of family role theory, social-class differences in the father's role, and recent change in expectations for men's parental role.This research was supported by NIMH Grant No. MH15735 and earlier by NICHD Grant No. HD 13103.     

PERCEIVING CINEMATIC EPISODES: A CROSS-CULTURAL REPERTORY GRID STUDY OF A NARRATIVE FILM SEGMENT*

Film theory has advanced concepts for explaining how it is possible for film viewers to understand what they are seeing. Many of these concepts strongly imply that the production of meaning of a film lies within the film itself - the viewer's role being reduced to that of passive spectator. This study tests that assumption using a repertory grid analysis of constructs elicited from Australian and Hong Kong Chinese subjects as they interpreted a segment of a commercial film. The results showed that the Australian sample construed more emotionally than did the Hong Kong Chinese, who responded more at the level of the film's characterisation. They were also more specific in their construals while the Australians were more diffuse. Further analysis suggested that differences between the two groups were the result of judgments about different attributes of the film, rather than because of different patterns of construing. It was concluded that since there are major differences in the two groups' interpretations of the same film, in the field of film/spectator studies where semiotics and psychology come together, the repertory grid analysis is a useful research tool.     

From print to sound in mature readers as a function of reader ability and two forms of orthographic regularity

Four experiments using college students as subjects provide evidence that both highly skilled and less skilled mature readers derive the names of printed words from visual access of the lexicon rather than by phonological recoding. Regularity of pronunciation (regular vs. exception words) as a variable of orthographic regularity effectiveafter visual code formation had no effect either between or within reading ability groups. Less skilled readers made more errors and were slower than highly skilled readers on both types of words. Sing-letter spatial redundancy, as a variable of orthographic regularity that influences the formation of visual codes, served to differentiate the two groups only in naming nonwords. Highly skilled readers used spatial redundancy to offset the effect of array length, whereas less skilled readers did not. Except for high-frequency words, visual access and retrieval of the pronunciation of words was significantly faster for highly skilled readers. Less skilled readers were most disadvantaged in naming nonwords, a task that requires phonological recoding. Overall results support the hypothesis that reading ability in mature readers is related to the speed of word recognition. Highly skilled readers may make more use of variables of orthographic regularity effective in the formation of visual codes.     

ELSI priorities for brain imaging

As one of the most compelling technologies for imaging the brain, functional MRI (fMRI) produces measurements and persuasive pictures of research subjects making cognitive judgments and even reasoning through difficult moral decisions. Even after centuries of studying the link between brain and behavior, this capability presents a number of novel significant questions. For example, what are the implications of biologizing human experience? How might neuroimaging disrupt the mysteries of human nature, spirituality, and personal identity? Rather than waiting for an ethical agenda to emerge from some unpredictable combination of the concerns of ethicists and researchers, the attention of journalists, or after controversy is sparked by research that cannot be retracted, we queried key figures in bioethics and the humanities, neuroscience, media, industry, and patient advocacy in focus groups and interviews. We identified specific ethical, legal and social issues (ELSI) that highlight researcher obligations and the nonclinical impact of the technology at this new frontier.     

Genetic Testing of Children for Predisposition to Mood Disorders: Anticipating the Clinical Issues

Large-scale sequencing information may provide a basis for genetic tests for predisposition to common disorders. In this study, participants in the Coriell Personalized Medicine Collaborative (N?=?53) with a personal and/or family history of Major Depressive Disorder or Bipolar Disorder were interviewed based on the Health Belief Model around hypothetical intention to test one’s children for probability of developing a mood disorder. Most participants (87 %) were interested in a hypothetical test for children that had high (“90 %”) positive predictive value, while 51 % of participants remained interested in a modestly predictive test (“20 %”). Interest was driven by beliefs about effects of test results on parenting behaviors and on discrimination. Most participants favored testing before adolescence (64 %), and were reluctant to share results with asymptomatic children before adulthood. Participants anticipated both positive and negative effects of testing on parental treatment and on children’s self-esteem. Further investigation will determine whether these findings will generalize to other complex disorders for which early intervention is possible but not clearly demonstrated to improve outcomes. More information is also needed about the effects of childhood genetic testing and sharing of results on parent–child relationships, and about the role of the child in the decision-making process.