Multilevel Perspectives on Community Intervention: An Example from an Indo-US HIV Prevention Project in Mumbai, India

This paper explores the meaning and applicability of multilevel interventions and the role of ethnography in identifying intervention opportunities and accounting for research design limitations. It utilizes as a case example the data and experiences from a 6-year, NIMH-funded, intervention to prevent HIV/STI among married men in urban poor communities in Mumbai, India. The experiences generated by this project illustrate the need for multilevel interventions to include: (1) ethnographically driven formative research to delineate appropriate levels, stakeholders and collaborators; (2) identification of ways to link interventions to the local culture and community context; (3) the development of a model of intervention that is sufficiently flexible to be consistently applied to different intervention levels using comparable culturally congruent concepts and approaches; (4) mechanisms to involve community residents, community based organizations and community-based institutions; and (5) approaches to data collection that can evaluate the impact of the project on multiple intersecting levels.     

Emotional responding in depression: Distinctions in the time course of emotion

The current studies were designed to investigate if the emotion context insensitivity hypothesis (ECI; Rottenberg & Gotlib, 2004) is applicable across the time course of emotion. Recent affective science research has pointed to the importance of considering anticipation and maintenance of emotion. In the current studies, we assessed emotion responses among college students with depression symptoms in anticipation of, during, and after an emotional picture using the emotion modulated startle paradigm. People with and without depression symptoms did not differ in blink magnitude in anticipation of emotional pictures suggesting that some anticipatory processes may not be impaired by depression symptoms. In contrast, individuals with depression symptoms did not exhibit blink magnitudes that varied by valence, either during viewing or after the pictures were removed from view. These findings suggest that ECI is relevant not only for those diagnosed with major depressive disorder, but also for people with depression symptoms that may not cross the diagnostic threshold. These data also point to the importance of considering the time course of emotion to better understand emotional deficits in individuals with differing levels of depression symptoms. Identifying where emotion goes awry across the time course of emotion can help inform treatment development.     

Refining the dual‐process theory of preference construction: A reply to Gawronski,Martin and Sloman,Stanovich, and Wegener and Chien

Our target article proposed a dual-system framework for understanding context and task effects in choice. In this summary, we address the major points made by each set of commentators and, building on their suggestions, define a more precise dual-system theory of preference construction. We also propose some avenues for future research on a broader dual-system approach to understanding choice.     

Between a rock and a hard place? Locus of control,religious problem-solving and psychological help-seeking

Drawing on a college and community sample, this study utilised hierarchical multiple regression to examine the relative contributions of demographic variables, psychological treatment experience, religious service attendance, locus of control, and religious problem-solving style in predicting attitudes towards psychological help-seeking. Women, those holding a graduate degree, and those with treatment experience held more positive attitudes towards psychological help-seeking. While neither the locus of control nor religious problem-solving scales alone were related to help-seeking, several significant interaction effects were observed. God-centred locus of control was a positive predictor of psychological help-seeking, but only for older participants. Chance locus of control was a negative predictor, but only for graduate degree holders. Last, self-directing religious problem-solving style was a negative predictor, especially for individuals also endorsing a deferring religious problem-solving style. Perhaps the composition of the sample – largely educated, religious African-American women – gives some insight into the complex nature of these results.     

On the (In)Compatibility of Attitudes Toward Peace and War

Although attitudes toward peace and war are usually treated as two opposite poles of one dimension, in this article we argue that they may represent two distinct dimensions. To investigate this idea, we developed and tested a new balanced measure, the Attitudes Toward Peace and War (APW) Scale, in three studies (N = 4,742) in the United States and Denmark. Exploratory and confirmatory factor analyses showed that attitudes toward peace and war formed two distinct, though negatively related, factors. Structural equation modeling showed that antecedents of attitudes toward peace included egalitarian ideological beliefs, the values of international harmony and equality, and empathic concern for others, and consequences included intentions to engage in peace‐related activities. On the other hand, antecedents of attitudes toward war included authoritarian ideological beliefs, the values of national strength and order, and less personal distress, and consequences included intentions to engage in warlike activities. Results also showed that political affiliation had an impact on the relationship between peace and war attitudes, with conservatives less likely to find the attitudes incompatible. The findings support the view that attitudes toward peace and war represent two distinct dimensions.     

The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles,Practices, and Patients,” a level one international meeting,Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute,Thrissur, Kerala,India, October 23–27, 2013

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013.     

Quality of Life and Bladder Management post Spinal Cord Injury: A Systematic Review

To explore the relationship between neurogenic bladder management techniques and quality of life (QoL) among individuals with spinal cord injury (SCI). A key terms literature search was conducted in multiple electronic databases (i.e., MEDLINE, CINAHL, EMBASE, and PsycINFO). Studies published up to and including May 2013 were reviewed and evaluated based on the following criteria: (1) full-length journal article published in the English language; (ii) human subjects ≥18 years; (iii) ≥?50 % of subjects had a SCI; (iv) results on QoL, as it related to bladder management method, were reported for at least three subjects. A total of 422 articles were extracted and upon review of titles and abstracts, 7 studies met the inclusion criteria. There were two level 2 cohort studies and five level 5 observational studies. Sample sizes ranged from 37 to 282 with an average of 117.1 individuals per study. All participants were at least six months post injury. Bladder management methods used included intermittent (patient/attendant), indwelling (suprapubic/transurethral), and condom catheterization, micturition assistive maneuvers, and electrical stimulation. Normal voiders scored better in all QoL measure domains compared to other management methods. Those using attendant intermittent and indwelling catheterization scored the poorest on the domains Personal Relationships, Emotions, and Mental Health. There is insufficient evidence to provide a definite conclusion as to the relationship between bladder management methods and QoL post SCI. However, individuals relying on others to aid in voiding may experience lower QoL compared to those who are independent.     

Relations Between PTSD and Distress Dimensions in an Indian Child/Adolescent Sample Following the 2008 Mumbai Terrorist Attacks

Posttraumatic stress disorder’s (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849–854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764–776, 2010). However, debatable is whether the model’s dysphoria factor adequately captures all of PTSD’s emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126–135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD?=?1.33), with the majority being male (n?=?435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18’s depression and somatization factors related more to PTSD’s dysphoria than PTSD’s avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor’s complete accountability for PTSD’s inherent distress. Additionally, PTSD’s dysphoria factor related more to BSI-18’s depression than BSI-18’s anxiety/somatization factors; this may explain PTSD’s comorbidity mechanism with depressive disorders.     

Invented Spelling,Word Stress,and Syllable Awareness in Relation to Reading Difficulties in Children

The study assessed the clinical utility of an invented spelling tool and determined whether invented spelling with linguistic manipulation at segmental and supra-segmental levels can be used to better identify reading difficulties. We conducted linguistic manipulation by using real and nonreal words, incorporating word stress, alternating the order of consonants and vowels, and alternating the number of syllables. We recruited 60 third-grade students, of which half were typical readers and half were poor readers. The invented spelling task consistently differentiated those with reading difficulties from typical readers. It explained unique variance in conventional spelling, but not in word reading. Word stress explained unique variance in both word reading and conventional spelling, highlighting the importance of addressing phonological awareness at the supra-segmental level. Poor readers had poorer performance when spelling both real and nonreal words and demonstrated substantial difficulty in detecting word stress. Poor readers struggled with spelling words with double consonants at the beginning and ending of words, and performed worse on spelling two- and three-syllable words than typical readers. Practical implications for early identification and instruction are discussed.