Socially Valued Roles,Self‐Determination,and Community Participation among Individuals Living with Serious Mental Illnesses

Decades after deinstitutionalization, individuals living with serious mental illnesses remain isolated, socially disengaged, and devalued members of communities. Burgeoning research and services need conceptual clarity to improve such social conditions. This qualitative inquiry used grounded theory and participatory approaches to conduct an in‐depth exploration of community participation for individuals living with serious mental illnesses based on key stakeholder perspectives (n = 45). Results revealed that community participation is a multifaceted construct with layers of meaning for individuals living with serious mental illnesses. Overarching themes are contextualized in Self‐Determination Theory and presented with deidentified illustrations. Implications for services, research, and policy are discussed.     

Improving visual spatial working memory in younger and older adults: effects of cross-modal cues

Spatially informative auditory and vibrotactile (cross-modal) cues can facilitate attention but little is known about how similar cues influence visual spatial working memory (WM) across the adult lifespan. We investigated the effects of cues (spatially informative or alerting pre-cues vs. no cues), cue modality (auditory vs. vibrotactile vs. visual), memory array size (four vs. six items), and maintenance delay (900 vs. 1800 ms) on visual spatial location WM recognition accuracy in younger adults (YA) and older adults (OA). We observed a significant interaction between spatially informative pre-cue type, array size, and delay. OA and YA benefitted equally from spatially informative pre-cues, suggesting that attentional orienting prior to WM encoding, regardless of cue modality, is preserved with age. Contrary to predictions, alerting pre-cues generally impaired performance in both age groups, suggesting that maintaining a vigilant state of arousal by facilitating the alerting attention system does not help visual spatial location WM.     

Advocacy processes in mental health: a qualitative study

Advocates perform an important role in representing the rights of mental health consumers, especially since mental health consumers are often marginalized. Little is known about the processes advocates use to assist mental health consumers in navigating the health care system. This study details the manner in which advocates work together with mental health consumers and health professionals through presenting a qualitative synthesis of 60 case records. Four main themes emerged: negotiating on behalf of consumers during meetings with health professionals; liaising between consumers and health professionals outside of meetings; supporting consumer decision making without the involvement of health professionals; and involvement in legal processes. The findings of this study demonstrated that advocates were primarily oriented toward the protection of negative rights, but they also promoted positive rights.     

An Examination of the Individual‐Difference Approach to the Role of Norms in the Theory of Reasoned Action1

The relationship between subjective norm and behavioral intentions is the weakest link of the theory of reasoned action. Numerous approaches have addressed this issue, including the assertion that the weak contribution is a result of a small number of individuals who are under normative control. The present research examines this individual‐difference approach in the domain of health behaviors. Respondents were 287 students who rated their intentions, attitudes, and subjective norms in relation to 32 health behaviors and 5 substance‐use behaviors. Regression analyses, between subjects and within subjects, demonstrated that both behaviors and people can be under attitudinal or normative control. Support for an individual‐difference approach was less conclusive when findings were examined separately for specific health behaviors.     

Does Happiness Predict Medication Adherence among African Americans with Hypertension?

Poor medication adherence is a leading cause of excessive cardiovascular morbidity among African Americans. Many adherence-promoting interventions have addressed economic barriers, improved the patient-provider relationship, simplified regimens, and used reminder systems; however, the problem of low adherence remains intractable. Meanwhile, positive psychological attributes that might serve to promote medication adherence have not been fully explored. To address this gap, we examined the association between happiness and medication adherence among low-income African Americans with hypertension treated in a safety-net setting. Data were obtained from the Alabama Collaboration for Cardiovascular Equality, 2007?C2008. Happiness was measured using the 4-item scale of Lyubomirsky and Lepper; low, moderate, and high happiness were defined by tertiles because of the non-normal distribution. Medication adherence was assessed with the Morisky Medication Adherence Scale. Associations were quantified with ordinal logistic regression. Our sample of 573 African Americans was 71.6?% female and had an average age?±?SD of 53.6?±?9.7?years and a median happiness score of 5.2. Compared to participants with low happiness, the odds (OR; 95?% CI) of being in a better medication adherence category were greater for those with moderate (1.53; 1.02?C2.27) and high (2.26; 1.52-3.37) happiness, after adjusting for age, sex, income, education, and difficulty paying for medical care. Within this cohort of low-income African Americans with hypertension, participants with greater happiness exhibited better medication adherence. Although one interpretation of our study is that more adherent patients are naturally happier, our findings raise the possibility that adding happiness-boosting components may increase the effectiveness of more traditional adherence interventions.     

Aging and the discrimination of 3-D shape from motion and binocular disparity

Two experiments evaluated the ability of younger and older adults to visually discriminate 3-D shape as a function of surface coherence. The coherence was manipulated by embedding the 3-D surfaces in volumetric noise (e.g., for a 55?% coherent surface, 55?% of the stimulus points fell on a 3-D surface, while 45?% of the points occupied random locations within the same volume of space). The 3-D surfaces were defined by static binocular disparity, dynamic binocular disparity, and motion. The results of both experiments demonstrated significant effects of age: Older adults required more coherence (tolerated volumetric noise less) for reliable shape discrimination than did younger adults. Motion-defined and static-binocular-disparity-defined surfaces resulted in similar coherence thresholds. However, performance for dynamic-binocular-disparity-defined surfaces was superior (i.e., the observers?? surface coherence thresholds were lowest for these stimuli). The results of both experiments showed that younger and older adults possess considerable tolerance to the disrupting effects of volumetric noise; the observers could reliably discriminate 3-D surface shape even when 45?% of the stimulus points (or more) constituted noise.     

Voluntary Consent in Correctional Settings: Do Offenders Feel Coerced to Participate in Research?

A major ethical concern in research with criminal offenders is the potential for abuse due to coercive influences that may adversely affect offenders' capacity to give voluntary consent to participate in research conducted in correctional settings. Despite this concern, to date there have been almost no systematic scientific investigations of the extent to which offenders themselves perceive that coercion occurs in these settings or that it is likely to influence their decisions about research participation. In a sample of over 600 ethnically diverse men and women recruited from various prisons and community corrections facilities in Texas and Florida, we used a vignette-based survey concerning a hypothetical research project to measure and compare offenders' global perceptions of coercive processes, as well as the differential salience and perceived coercive influence of specific factors (e.g., coercion by other inmates, inducements from staff). Somewhat surprisingly, across multiple outcome measures our participants on average reported relatively little in the way of significant coercive influences on their capacity to make voluntary decisions concerning research participation. Implications and directions for future research on coercive influences in offender research are discussed.