Women's experiential journey toward voluntary childlessness: An interpretative phenomenological analysis

Voluntary childlessness is a relatively novel yet growing phenomenon. This idiographic study explored three women's experiential journeys toward voluntary childlessness. Semi‐structured interviews were carried out and analysed using Interpretative Phenomenological Analysis. Themes identified were: Owning the choice to be childless, social expectations, and models of mothering. Despite defining ‘voluntary childlessness’ as an unequivocal decision, the women's experiential accounts revealed an intrinsic fluidity in their journeys toward childlessness. Factors including beliefs in equality, independence and career aspirations competed with constructs of mothering/motherhood, partnership and choice to create a complex tapestry of contributory factors in these women's childlessness. The findings question the notion of choice and particularly women's ownership of that choice. The journeys toward childlessness these women shared reveal a synthesis of agentic decision‐making, personal histories and challenging lifestyle choices bound up within an existential need to be a woman. More research is needed to determine the place of voluntary childlessness within society. Copyright © 2010 John Wiley & Sons, Ltd.     

Accuracy of Reported Family History and Effectiveness of Medical Record Requests in Genetic Counseling for Alzheimer Disease

The University of British Columbia Hospital Clinic for Alzheimer Disease and Related Disorders (UBCH-CARD) invests significant effort to obtain medical records for the confirmation of patient–reported family histories of dementia. The effectiveness of requesting these records was assessed through a review of the 275 requests made by UBCH-CARD genetic counselors during the 24-month period of January 1, 2005–December 31, 2006. The results were categorized according to outcome. Useful medical records were obtained from 92 (33.5%) requests: 77 (28%) records supported, and 15 (5.5%) records did not support, the patient–reported information. An additional 20 (7.5%) requests yielded only vague information. When verification was possible, patient–reported family histories of Alzheimer disease, dementia, or memory loss were accurate in 84% of cases. During the study period, almost 500 h of genetic counselor work time was spent obtaining, reviewing, and following-up on records received. Changes made to UBCH-CARD procedure in response to these findings are discussed.     

Undisclosed Paternal Identity in Narratives of Distress Among Young People in Eastern Cape,South Africa

Life trajectories of children with no connections to support from their fathers have received research attention. Within this group is a sub-group who do not know their fathers and no research has attempted to understand their experiences. We present accounts of how young South Africans deal with and seek to uncover undisclosed paternity. Forty young men and women aged 16 to 22 volunteered to participate in a qualitative study on distress that was conducted in the Eastern Cape Province. All interviews were conducted in isiXhosa, following a semi-structured guide. Our findings show that interest in father identity was motivated by harsh circumstances in the maternal home, notably when financial difficulties, exclusion from critical decision making and bullying by non-biological siblings were felt. The search for father identity was pursued in solitude by some participants: their fear of elders’ response restrained them from asking. Some thought that it would be interpreted as being disrespectful and ungrateful to ask ‘such a question’, whilst others worried that they might be victimized or, worse, thrown out by their mothers or maternal guardians. We present accounts of accidental disclosures by strangers and also inadvertent involvement in an incestuous relationship. Open and honest communication with children about their paternal identity should be promoted to prevent the currents of silence, secrecy and anxiety, and avoid unpleasant surprises for the children.     

Age Differences and Similarities in Identity Distress Following the Katrina Disaster: Theoretical and Applied Implications of Erikson��s Theory

This study examined predictions from Erikson??s lifespan developmental theory in the context of severe disaster exposure. Relationships among traumatic stress exposure, age, identity distress, and posttraumatic stress (PTS) symptoms were explored among 401 individuals (age 18?C86, mean = 32.83, SD = 14.1 years) exposed to Hurricane Katrina. Traumatic exposure experiences were related to identity distress ratings, but results suggested that the association was a function of PTS symptoms. Identity distress was negatively correlated with age, but the association between identity distress and age was moderated by the level of PTS symptoms. Identity distress was associated with PTS symptoms even while controlling for general psychological symptoms. The utility of the identity distress construct and theoretical implications for identity research in the wake of disaster are discussed.     

Rasch analysis of the Hospital Anxiety and Depression Scale in spinal cord injury

Purpose: The purpose of this study was to evaluate the psychometric properties of the Hospital Anxiety and Depression Scale (HADS), applied among persons with spinal cord injury (SCI), using Rasch analysis. Methods: A cross-sectional multicenter study was conducted and the data of 102 people with SCI were analyzed. Rasch analyses were performed to assess dimensionality, overall and individual item fit, response scale structure, targeting, and differential item functioning. Results: The anxiety and depression subscales showed unidimensionality, that is, model and item fit. The two subscales are reliable (r = .72, 0.82) in SCI. No disordered structure of the response scales or differential item functioning in age, gender, education, relationship status, level of spinal lesion were found. Stepwise deletion of the misfitting items did not produce a total score that fulfilled the statistical criteria for unidimensionality. Conclusions: The results of the Rasch analyses support the use of the anxiety and depression subscales among people with SCI. However, further research is needed to confirm these findings and examine sensitivity to change of the HADS in SCI, which would support its use in longitudinal observational and intervention studies. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Using the Interactive Systems Framework to Support a Quality Improvement Approach to Dissemination of Evidence-Based Strategies to Promote Early Detection of Breast Cancer: Planning a Comprehensive Dynamic Trial

Dissemination efforts must optimize interventions for new settings and populations. As such, dissemination research should incorporate principles of quality improvement. Comprehensive Dynamic Trial (CDT) designs examine how information gained during dissemination may be used to modify interventions and improve performance. Although CDT may offer distinct advantages over static designs, organizing the many necessary roles and activities is a significant challenge. In this article, we discuss use of the Interactive Systems Framework for Dissemination and Implementation to systematically implement a CDT. Specifically, we describe “Bronx ACCESS”, a program designed to disseminate evidence‐based strategies to promote adherence to mammography guidelines. In Bronx ACCESS, the Intervention Delivery System will elicit information needed to adapt strategies to specific settings and circumstances. The Intervention Synthesis and Translation System will use this information to test changes to strategies through “embedded experiments”. The Intervention Support System will build local capacities found to be necessary for intervention institutionalization. Simulation modeling will be used to integrate findings across systems. Results will inform on‐going policy debate about interventions needed to promote population‐level screening. More generally, this project is intended to advance understanding of research paradigms necessary to study dissemination. Special Issue: Advances in Bridging Research and Practice Using the Interactive System Framework for Dissemination and Implementation; Guest Editors: Abraham Wandersman, Paul Flaspohler, Catherine A. Lesesne, Richard Puddy; Action Editor: Emilie Phillips Smith     

Sentence processing in Lewy body spectrum disorder: the role of working memory

Prior work has related sentence processing to executive deficits in non-demented patients with Parkinson's disease (PD). We extended this investigation to patients with dementia with Lewy bodies (DLB) and PD dementia (PDD) by examining grammatical and working memory components of sentence processing in the full range of patients with Lewy body spectrum disorder (LBSD). Thirty-three patients with LBSD were given a two-alternative, forced-choice sentence-picture matching task. Sentence type, working memory, and grammatical structure were systematically manipulated in the sentences. We found that patients with PDD and DLB were significantly impaired relative to non-demented PD patients and healthy controls. The deficit in PDD/DLB was most pronounced for sentences lengthened by the strategic placement of an additional prepositional phrase and for sentences with an additional proposition due to a center-embedded clause. However, there was no effect for subject-relative versus object-relative grammatical structure. An MRI voxel-based morphometry analysis in a subset of patients showed significant gray matter thinning in the frontal lobe bilaterally, and this extended to temporal, parietal and occipital regions. A regression analysis related sentence processing difficulty in LBSD to frontal neocortex, including inferior prefrontal, premotor, and dorsolateral prefrontal regions, as well as right superior temporal cortex. These findings are consistent with the hypothesis that patients with PDD and DLB have difficulty processing sentences with increased working memory demands and that this deficit is related in part to their frontal disease.     

A gender difference in the false recall of negative words: women DRM more than men

Gender differences in susceptibility to associative memory illusions in the Deese/Roediger-McDermott paradigm were investigated using negative and neutral word lists. Women (n=50) and men (n=50) studied 20 lists of 12 words that were associates of a non-presented critical lure. Ten lists were associates of negatively valenced lures (e.g., cry, evil) and ten were associates of neutral lures (e.g., chair, slow). When asked to recall the words after each list, women falsely recalled more negative lures than men, but there was no gender difference in the false recall of neutral lures. These findings suggest that women reflect on associations within negative lists to a greater degree than men and are thereby more likely to generate the negative critical lures.     

Shared cognitive processes underlying past and future thinking: the impact of imagery and concurrent task demands on event specificity

Recent literature has argued that whereas remembering the past and imagining the future make use of shared cognitive substrates, simulating future events places heavier demands on executive resources. These propositions were explored in 3 experiments comparing the impact of imagery and concurrent task demands on speed and accuracy of past event retrieval and future event simulation. Results provide support for the suggestion that both past and future episodes can be constructed through 2 mechanisms: a noneffortful "direct" pathway and a controlled, effortful "generative" pathway. However, limited evidence emerged for the suggestion that simulating of future, compared with retrieving past, episodes places heavier demands on executive resources; only under certain conditions did it emerge as a more error prone and lengthier process. The findings are discussed in terms of how retrieval and simulation make use of the same cognitive substrates in subtly different ways.