The next generation of psychological autopsy studies: part 2. Interview procedures

The psychological autopsy (PA) is a systematic method of assessing the psychological and contextual circumstances preceding suicide. The method requires interviews with one or more proxy respondents (i.e., informants) of suicide decedents. Procedural challenges that need to be addressed to conduct PA interviews are described in this article and recommendations for meeting these challenges in future PA investigations are made. Procedures addressed include determining the timing of PA interviews after suicide, designing the structure and flow of interviews, selection of proxy respondents, integrating interview data with information gathered from records, and selecting and training interviewers. This methodological article is the second in a two-part series-the first article focused on interview content.     

Mutual Humanization: A Visual Exploration of Relationships in Medical Care

In this article, I explore the work of the artist Robert Pope (b.1957- d.1992) who published a series of paintings and drawings which documented his decade-long experience with Hodgkin's lymphoma. More widely, Pope was interested in 'the culture' of cancer within hospitals and the relationships embedded in experiences of illness and care. Pope published a book that contains much of this work--Illness and Healing: Images of Cancer (1991). Many of the original artworks have been toured throughout Canada and the United Kingdom at cancer centres and medical schools. Using a visual methodology, I present three of Pope's images to examine and understand the experiences of patients within acute care settings. I conclude that Pope's work can be efficacious in exploring relationships in acute care settings.     

Psychosocial Functioning in Children and Adolescents with Extreme Obesity

The aim of this study was to investigate the psychosocial differences among obese pediatric patients, particularly those who are "extremely obese" as compared to "obese." Information was collected for 249 subjects at a multidisciplinary treatment clinic for obese youth. A battery of measures was administered and demographic data and height/weight was obtained. The results showed positive correlations between degree of obesity, psychosocial functioning, and quality of life. Specifically, the "extremely obese" were significantly more depressed, more socially anxious, and had poorer quality of life than the "obese" group. Girls and Caucasians were more socially anxious than boys and African Americans, respectively. There is mounting evidence that children and adolescents who are extremely obese are most at risk for psychiatric and medical disorders. Thus, targeting this group for assessment and/or designing treatment options specific for "extremely obese" youth is critical for the successful management of this population.     

The six most essential questions in psychiatric diagnosis: a pluralogue part 3: issues of utility and alternative approaches in psychiatric diagnosis

In face of the multiple controversies surrounding the DSM process in general and the development of DSM-5 in particular, we have organized a discussion around what we consider six essential questions in further work on the DSM. The six questions involve: 1) the nature of a mental disorder; 2) the definition of mental disorder; 3) the issue of whether, in the current state of psychiatric science, DSM-5 should assume a cautious, conservative posture or an assertive, transformative posture; 4) the role of pragmatic considerations in the construction of DSM-5; 5) the issue of utility of the DSM ?C whether DSM-III and IV have been designed more for clinicians or researchers, and how this conflict should be dealt with in the new manual; and 6) the possibility and advisability, given all the problems with DSM-III and IV, of designing a different diagnostic system. Part 1 of this article took up the first two questions. Part 2 took up the second two questions. Part 3 now deals with Questions 5 & 6. Question 5 confronts the issue of utility, whether the manual design of DSM-III and IV favors clinicians or researchers, and what that means for DSM-5. Our final question, Question 6, takes up a concluding issue, whether the acknowledged problems with the earlier DSMs warrants a significant overhaul of DSM-5 and future manuals. As in Parts 1 & 2 of this article, the general introduction, as well as the introductions and conclusions for the specific questions, are written by James Phillips, and the responses to commentaries are written by Allen Frances.     

Prospective memory reminders: a laboratory investigation of initiation source and age effects

Prior research indicates that, in some circumstances, reminders may facilitate prospective remembering. However, it remains unclear whether this effect is dependent on the initiation source (self vs. external), whether it is moderated by task type (event vs. time based), or whether the provision of standardized reminders particularly benefits older adults. In the current study, young (n?=?48) and older adults (n?=?47) were tested on a laboratory-based prospective memory task in which they encountered three counterbalanced reminder conditions: no reminders, self-initiated reminders, and experimenter-initiated reminders. The results indicated that while the provision of reminders enhanced prospective memory performance, no difference was seen between self-initiated and experimenter-initiated reminder conditions, nor was there any interaction with age or prospective memory type (event vs. time based). These data support the role of both self- and externally generated external reminders as an aid to prospective remembering. However, the absence of any interaction with age is not consistent with theoretical models of ageing that consider the provision of such reminders to reduce strategic demands (or increase automatic processing).     

Toward a Feminist and Multicultural Model of Consultation and Advocacy

The authors present core ideas or constructs that might be integral to a feminist and multicultural model of consultation. According to the model, the structure of consultation is (a) nonhierarchical and (b) an open triad (incorporating extrapersonal and outside factors). The process of consultation is (c) culturally responsive and (d) empowering. The role of the consultant is as (e) an agent for change and (f) an advocate for both the client and the system. Los autores y sus ideas centrales presente o construyentes quizás sea integral para una feminista y un modelo de la consulta multicultural. Según el modelo, la estructura de la consulta es (a) nonhierarchical y (b) una tríada abierta (incorporando extrapersonal y factores exteriores). El proceso de la consulta es (c) culturalmente receptiva y (d) autorizada. El papel del consultor es como (e) un agente para el cambio y (f) un defensor para el cliente y el sistema.     

AIDS and intimate relationships: Adolescents’ knowledge and attitudes

The knowledge level about HIV/AIDS among American adolescents aged 16 to 19 has been assessed on several occasions, showing that in recent years their knowledge base has improved. The knowledge bases of British adolescents and of adolescents younger than 16 have been largely ignored. In attempting to assess the likely impact on present or future behaviors of increasing adolescents’ knowledge base about AIDS it is important to also know something of adolescents’ attitudes to intimate relationships and to sex within those relationships. Previous studies have not linked these two aspects. In this study two hundred London schoolchildren aged 14 and 15 years completed a questionnaire tapping both their knowledge about HIV infection and its transmission and their attitudes to intimate relationships. Their answers revealed that they had absorbed the simple media messages about AIDS, that it kills and that use of a condom during sex offers protection. However they were less well informed on detailed aspects of prevention, although, worryingly, they believed that they knew all that they needed to about preventive measures. The majority had attitudes to intimate relationships that were compatible with the message of restricting their number of sexual partners; however, a significant minority did not. The latter were more likely to deny the risk associated with promiscuity. It is suggested that school-based AIDS education programs should help individuals to develop new attitudes to intimate relationships that are compatible with risk avoidance.     

Remarks in praise of guilt

This article is an elaboration and extension of an earlier article concerned with guilt and morality in the modern age. The focus is on two general issues arising from what was presented there. First, there is an attempt to explicate the conception of human agency underlying the emphasis on individual responsibility in the original essay. Second, there is a critical examination of the moral relativism position so common in the contemporary world. Both the shrinking conception of human agency and responsibility and the growing acceptance of moral relativism are strongly criticized, and it is concluded that a rationally-based morality must be defended against those many persons today for whom ‘anything goes’ in the realm of human behavior.     

Sex-role stereotypes and clinical judgments of mental health: The Brovermans' findings reexamined

This study attempted to evaluate the progress of mental health professionals regarding sex-role stereotyping in clinical functioning, identified as a problem over 10 years ago by Broverman et al. (Journal of Consulting and Clinical Psychology, 1970, 34, 1–7). A comparable format and questionnaire were used in order to replicate faithfully the earlier study and facilitate past-present comparisons. One hundred four psychiatrists, psychologists, and social workers were randomly assigned to three instruction-set conditions in completing the Stereotype Questionnaire: sexunspecified adult instruction set, female instruction set, and male instruction set. No significant differences were found related to sex of clinician. A significant effect (p<.001) was found for social desirability and what was judged as healthy for sex-unspecified adults. No significant relationship was found, however, for social desirability of traits and conventional sex-role stereotypes. Based on the results of this study it is possible to speculate either that the Boverman results were primarily an artifact of their forced-choice methodology or that progress has been made in a more nonsexist direction among mental health professionals. Limitations of this research are presented and considered relative to the Brovermans' study. The basically attitudinal nature of this work is noted and the question is raised as to whether nonsexist attitudes are translated into nonsexist clinical functioning.     

Worksite stress management interventions

Despite the general agreement that stress plays a role in everyday life, there continues to be substantial controversy about how stress can be managed at the worksite. During the last decade, our knowledge of stress management interventions has increased substantially. Despite this improvement, deficiencies in the literature exist. In this article, we offer a framework that may be used for viewing organizational stress interventions, briefly review some of the stress management intervention literature in the context of this framework, and identify future needs that may be particularly appropriate for organizational psychologists to address.