Using Cognitive Mapping to Understand Problems Experienced by Family Caregivers of Persons with Severe Physical Disabilities

Individuals who provide ongoing care for family members who have a chronic disease or disability are likely to encounter a wide array of problems that can compromise their own health and their ability to function effectively in a caregiving role. Structured focus group meetings were conducted to elicit a comprehensive list of the problems that caregivers experienced during their first year of providing care to a person with a severe physical disability. A separate group of caregivers (N = 60) individually sorted problems into piles based on their similarity and assigned relative importance to each problem. The aggregated data were analyzed with multidimensional scaling and hierarchical cluster analysis. Results indicated that caregivers cognitively organize problems along three dimensions: I. Centeredness–caregiver versus patient-oriented; II. Relationship Demands–physical versus emotional; and III. Caregiver Burden–time versus emotional. Additionally, 6 clusters of substantively similar problems were identified and prioritized in terms of personal relevance: Basic Needs (lowest); Perceived Constraints; Caregiver Challenges; Patient Resentment; Patient Withdrawal; and Patient Intrapsychic Adjustment (highest). Further examination of the organization of problems identified by caregivers should provide important insights about the experience of caregivers and how more targeted interventions can be developed to address their specific needs.     

Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation

We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen’s d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.     

Why Do People Join Groups? Three Motivational Accounts from Social Psychology

This paper describes and contrasts three contemporary social psychological theories that focus on why people join and identify with groups: the sociometer model, terror management theory, and uncertainty–identity theory. The sociometer model argues that people have a need to be socially included, and that self‐esteem is a meter of successful inclusion and group belonging. Terror management theory argues that people are motivated to reduce fear of the inevitability of their own death, and that the consensual belief–confirmation provided by groups drives people to belong. Uncertainty–identity theory argues that people have a basic need to reduce uncertainty about themselves, their attributes, and their place in the world, and that cognitive processes associated with group identification reduce such uncertainty. We critically contrast these three accounts to conclude that all three motivational processes may play a role, but that self‐uncertainty may have the benefit of wide generality to all groups and group contexts and of detailed specification of cognitive processes.     

In Search of Common Threads: Linking Multicultural,Feminist, and Social Justice Counseling Paradigms

Multicultural, feminist, and social justice counseling theories are often viewed as disparate helping models. This article examines the complementary nature of these models and discusses the need to promote a clearer understanding of the ways in which these common threads can be used in counseling practice.     

Racial Microaggressions Against Black Americans: Implications for Counseling

Racial microaggression themes were identified using a focus‐group analysis of self‐identified Black participants. Six categories of demeaning and invalidating messages reflected beliefs of White supremacy that were unintentionally conveyed by perpetrators. Implications for counselors and the counseling process are discussed.     

Characterization and sociocultural predictors of neuropsychological test performance in HIV+ Hispanic individuals

Hispanic individuals in the U.S. have been disproportionately impacted by HIV/AIDS, yet little is known regarding the neuropsychological sequelae of HIV within the Hispanic population. This study characterized neuropsychological (NP) test performance of HIV+ English-speaking Hispanic participants (n = 51) and investigated the combined roles of sociocultural factors (e.g., ethnicity, socioeconomic status [SES] proxy, and reading level) on NP test performance among our HIV+ Hispanic and non-Hispanic White participants (n = 49). Results revealed that the pattern of NP impairment in HIV+ Hispanic participants is consistent with the frontal-striatal pattern observed in HIV-associated CNS sequelae, and the overall prevalence of global NP impairment was high compared to previous reports with more ethnically homogeneous, non-Hispanic White cohorts. Multivariate prediction models that considered both sociocultural factors and CD4 count revealed that reading level was the only unique predictor of global NP functioning, learning, and attention/working memory. In contrast, ethnicity was the only unique predictor of abstraction/executive functioning. This study provides support for the use of neuropsychological evaluation in detecting HIV-associated NP impairment among HIV+ Hispanic participants and adds to the growing literature regarding the importance of considering sociocultural factors in the interpretation of NP test performance.     

Resilient, undercontrolled, and overcontrolled personality prototypes among persons with spinal cord injury

A sample of 199 persons with spinal cord injury (SCI) were assessed on Big Five personality dimensions using the NEO Five-Factor Inventory (NEO-FFI; Costa & McCrae, 1992) at admission to an inpatient medical rehabilitation program. A cluster analysis of the baseline NEO-FFI yielded 3 cluster prototypes that resemble resilient, undercontrolled, and overcontrolled prototypes identified in many previous studies of children and adult community samples. Compared with normative samples, this sample had significantly fewer resilient prototypes and significantly more overcontrolled and undercontrolled prototypes. Undercontrolled individuals were the modal prototype. The resilient and undercontrolled types were better adjusted than the overcontrolled types, showing lower levels of depression at admission and higher acceptance of disability at discharge. The resilient type at admission predicted the most effective reports of social problem-solving abilities at discharge and the overcontrolled type the least. We discuss the implications of these results for assessment and interventions in rehabilitation settings.     

Communal Behaviors and Psychological Adjustment of Family Caregivers and Persons With Spinal Cord Injury

OBJECTIVE: Examined the influence of mutual communal behaviors on the adjustment reported by persons with spinal cord injury (SCI) and their family caregivers. Previous research has found that persons who have a history of mutually communal behaviors in relationships may react differently to relationship changes after an acquired physical disability than dyads with few communal behaviors. METHOD: Family caregivers and persons with SCI were administered measures of mutual communal behaviors, depression, and life satisfaction. Structural equation modeling was used to test the relations among caregivers' communal behaviors and care recipients' communal behaviors, depression, and life satisfaction. RESULTS: Caregiver and care recipient reports of communal behaviors were not significantly correlated. Significant paths indicated that care recipients' communal behavior scores were positively associated with their life satisfaction, and care recipients' depression was inversely associated with their life satisfaction. Caregivers' communal behavior scores were unrelated to their self-reported adjustment. CONCLUSIONS: Caregiver-care recipient dyads may differ in their perceptions of communal behaviors in their relationships. Although care recipient reports of communal behavior may be related to their life satisfaction, communal behaviors may not serve a similar function among caregivers of persons with SCI.     

Ethnic Diversity and the Use of Humor in Counseling: Appropriate or Inappropriate?

Humor can reflect the healthy release of feelings during the counseling process, the type of emotional release that leads to significant therapeutic gains. It can also be a disturbing distraction, possibly causing early termination, if used inappropriately. Counselors need to exert particular caution before attempting to apply humor in working with a client from a culture different from the counselor's. This article explores the available literature and offers contributions on the subject from 4 “ethnically diverse” perspectives. Finally, a general approach based on existential theory is presented along with 5 general conditions to ascertain the appropriate use of humor.     

Abstract-concept learning and list-memory processing by capuchin and rhesus monkeys

Three capuchin monkeys (Cebus apella) touched the lower of 2 pictures (same) or a white rectangle (different), increased same/different abstract-concept learning (52% to 87%) with set-size increases (8 to 128 pictures), and were better than 3 rhesus monkeys (Macaca mulatta). Three other rhesus that touched the top picture before choices learned similar to capuchins but were better at list-memory learning. Both species' serial position functions were similar in shape and changes with retention delays. Other species showed qualitatively similar shape changes but quantitatively different time-course changes. In abstract-concept learning, qualitative similarity was shown by complete concept learning, whereas a quantitative difference would have been a set-size slope difference. Qualitative similarity is discussed in relation to general-process versus modular cognitive accounts.