Spiritual and emotional determinants of health

Within our present health care system, there is a growing movement that argues that our perceptions of health and illness are in need of change. This change includes redefining what we mean by health in terms of the whole person—the emotional, social, and spiritual dimensions of our being, as well as the physical. An increasing number of health professionals and social scientists believe our concepts of health and illness must consider all these aspects of life. It is believed that the quality of life may be enhanced by such perceptions of health, which include social and spiritual factors. Using data from the 1985 Akron Area Survey—The Subjective Quality of Life in the Akron Area—this study explores the effects of spiritual well-being and emotional well-being on health satisfaction. Results indicate that emotional and spiritual factors do significantly contribute to the subjective evaluation of health, especially for individuals who are physically limited.An earlier draft of this paper was presented at the joint session of the Association for the Sociology of Religion and the American Sociological Association, August 20, 1986. The author would like to thank Margaret Poloma, Ph.D., The University of Akron, and Mark Tausig, Ph.D., The University of Akron, for their helpful comments.     

The assessment of child abuse potential and the prevention of child abuse and neglect: A policy analysis

A frequently advocated strategy for increasing the efficiency of child abuse prevention programs is to deliver prevention services to "high-risk" populations. This article critically reviews procedures for the reliable and valid assessment of child abuse potential within an ecological perspective. Factors that limit the usefulness of child abuse risk assessment are discussed. These factors include the uncertain criteria of child abuse and neglect, the low base rate of the phenomenon, and the financial and social costs of such procedures. Finally, the prevention implications of the current and future state of the art in child abuse risk assessment are considered and preventive interventions that do not depend on individual case risk screening are advocated.     

A reanalysis of the influence of a "friendly visitor" program

A paper in the American Journal of Community Psychology (AJCP), by Reinke, Holmes, and myself, reported the results of a study of the influence of a friendly visitor program on the cognitive functioning and morale of elderly individuals. The program was reported to have had a significant multivariate effect on a combination of cognitive and morale measures and significant univariate effects on memory, self-perceived health, and activity director's ratings. Being intrigued by the memory finding, I conducted a follow-up study to further investigate the effect of a visitation program on cognitive functioning. In this second study the dependent measures included all of the cognitive variables included in the original study as well as some additional memory variables. The visitation program in the follow-up study had no effect on any of these measures. As a result of my failure to obtain a significant memory effect such as that reported in Reinke et al. (1981), I reanalyzed the data from the original study. In my reanalysis, the only significant effect was a borderline univariate effect for self-perceived health; the multivariate effect did not approach significance. On the basis of my inability to produce the results reported in Reinke et al. when I reanalyzed the original data, I must conclude that the friendly visitor program did not have the effects attributed to it in the original report.     

Frontal amnesia and the dysexecutive syndrome

This study analyzes the memory deficits shown by an amnesic patient with bilateral frontal damage and a dysexecutive syndrome. He resembles a classic amnesic patient in showing grossly impaired episodic memory for both verbal and nonverbal material, together with normal digit span, and on occasion normal recency in free recall. He differs from the classic amnesic pattern however in showing an impairment in both the speed and accuracy of performance on tests of semantic memory, and in clear evidence for impaired performance on some though not all procedural learning tasks. Finally, his autobiographical memory was poor and subject to substantial confabulation. It is suggested that the pattern of deficits is consistent with a combination of a classic amnesic syndrome with the additional problems associated with the frontal dysexecutive syndrome, rather than exhibiting a qualitatively different form of amnesia.     

A comparison of alternative theoretical approaches to smoking cessation and relapse

Two theoretical approaches to smoking cessation were compared. Participants were randomly assigned either to (a) a traditional treatment program that used contingency contracting and that emphasized the necessity for absolute abstinence (AA) or to (b) a relapse-prevention (RP) treatment that focused on gradual acquisition of nonsmoking skills. It was hypothesized that participants in the RP treatment would be less successful initially but would have better maintenance skills and thus would relapse less during a 1-year follow-up period. Each program was evaluated in two formats: group-based treatment and self-help materials. Results indicated comparable 1-year abstinence rates for all treatments, although more participants dropped out of the self-help formats. Participants in the RP intervention were more likely to lapse sooner after quitting and were more likely to quit again during the 1-year maintenance period. Exploratory analyses of successful participants suggested that women were more successful in the RP program and that men had greater success with the AA approach.     

The precaution adoption process

This article presents a critique of current models of preventive behavior. It discusses a variety of factors that are usually overlooked-including the appearance of costs and benefits over time, the role of cues to action, the problem of competing life demands, and the ways that actual decision behavior differs from the rational ideal implicit in expectancy-value and utility theories. Such considerations suggest that the adoption of new precautions should be viewed as a dynamic process with many determinants. The framework of a model that is able to accommodate these additional factors is described. This alternative model portrays the precaution adoption process as an orderly sequence of qualitatively different cognitive stages. Data illustrating a few of the suggestions made in the article are presented, and implications for prevention programs are discussed.     

Orientation discrimination and cortical function in the human newborn

There is some controversy concerning whether or not the visual abilities of the newborn are mediated entirely through subcortical pathways or whether the visual cortex is functioning at birth. A critical test of cortical functioning is discrimination of orientation: orientation-selective neurons are found in the visual cortex but not in subcortical parts of the visual system. An experiment is described in which newborn infants were habituated to a square-wave grating oriented 45 degrees from vertical. After habituation, significant preferences for the novel, mirror-image, grating were found, a result which argues for some degree of visual cortical functioning at birth.