Internet-based intervention for mental health and substance use problems in disaster-affected populations: a pilot feasibility study

Early interventions that reduce the societal burden of mental health problems in the aftermath of disasters and mass violence have the potential to be enormously valuable. Internet-based interventions can be delivered widely, efficiently, and at low cost and as such are of particular interest. We describe the development and feasibility analysis of an Internet-delivered intervention designed to address mental health and substance-related reactions in disaster-affected populations. Participants (n = 285) were recruited from a cohort of New York City-area residents that had been followed longitudinally in epidemiological research initiated 6 months after the terrorist attacks of September 11, 2001. The intervention consisted of 7 modules: posttraumatic stress/panic, depression, generalized anxiety, alcohol use, marijuana use, drug use, and cigarette use. Feasibility data were promising and suggest the need for further evaluation.     

Posttraumatic stress disorder in the general population after mass terrorist incidents: considerations about the nature of exposure

Epidemiologically, disasters represent multiple forms of possible exposures, including exposure type (eg, natural versus human-made), intensity, and duration. It has been suggested that the consequences of human-made disasters (eg, terrorist incidents) may be more severe than those of natural disasters; recent evidence suggests that there may be a high prevalence of posttraumatic stress disorder (PTSD) among both direct survivors of such attacks and in the general population. Several studies after the September 11, 2001, terrorist attacks found that the prevalence of PTSD was higher in New York City than it was in the rest of the US and that there was a substantial burden of PTSD among persons who were not directly affected by the attacks. This raises important questions about the meaning of "exposure" to a disaster. Using data from an assessment of PTSD in the first 6 months after September 11th we considered the nature of the PTSD experienced by persons who were not directly affected by the September 11th attacks. These data suggest that persons in the general population may have clinically important posttraumatic stress symptomatology after a mass terrorist incident. Future research should consider mechanisms through which persons in the general population may be at risk for PTSD after such incidents.     

Cognitive changes following subthalamic nucleus stimulation in two patients with Parkinson disease

The limits of a drug therapy in severe forms of Parkinson disease have led to refining neurosurgery on the basal ganglia. Deep brain stimulation of the subthalamic nucleus has been recognized as one of the most promising techniques to decrease "off" motor symptoms and motor fluctuations, allowing a reduction of drug therapy and limiting side effects of the drugs. There is still open debate on the possible consequences of chronic subthalamic stimulation in other ways, apart from motor symptoms, of general cognitive performance. We examined and followed two patients with Parkinson disease for 9 mo. after surgery for deep stimulation, studying their cognitive performances. There is a general amelioration of cognitive performances, in particular as far as linguistic capabilities is concerned. We discuss the possible significance of these results, reminding strenuously that only two patients were involved, so the potential for generalization is seriously limited.     

Predication and cognitive context: Between minimalism and contextualism

In this paper, we suggest a strategy for modelling cognitive context within a truth‐conditional semantics, using Asher's model of predication. This allows us to introduce the notion of type presupposition intended as a lexical constraint to the composition of the truth‐conditional content. More specifically, we suggest that this model of predication produces a notion of truth‐conditional meaning where the cognitive context fixes a set of lexical restrictions and forced modifications. We conclude that this model might offer an intermediate position between Minimalism and Contextualism: an account that provides intuitive truth conditions within a formal semantic theory.     

Religious Coping and Psychological and Behavioral Adjustment After Hurricane Katrina

Positive and negative religious coping are related to positive and negative psychological adjustment, respectively. The current study examined the relation between religious coping and PTSD, major depression, quality of life, and substance use among residents residing in Mississippi at the time of Hurricane Katrina. Results indicated that negative religious coping was positively associated with major depression and poorer quality of life and positive religious coping was negatively associated with PTSD, depression, poorer quality of life, and increased alcohol use. These results suggest that mental health providers should be mindful of the role of religious coping after traumatic events such as natural disasters.     

Prestige in interest activity assessment

Prestige has been demonstrated to be a component in interest assessment [Tracey, T. J. G. (1997). The structure of interests and self-efficacy expectations: An expanded examination of the spherical model of interests. Journal of Counseling Psychology, 44, 32-43; Tracey, T. J. G. (2002). Personal Globe Inventory: Measurement of the spherical model of interests and competence beliefs [Monograph]. Journal of Vocational Behavior, 60, 113-172; Tracey, T. J. G., & Rounds, J. (1996a). The spherical representation of vocational interests. Journal of Vocational Behavior, 48, 3-41]. However, the content of prestige and thus its meaning in activity and competency preferences has not been clarified, nor has it been differentiated from alternative explanations such as sex-typing. A vector fitting procedure was utilized from theoretical and empirical approaches with samples of college students who rated each activity item from the Personal Globe Inventory (PGI; [Tracey, T. J. G. (2002). Personal Globe Inventory: Measurement of the spherical model of interests and competence beliefs [Monograph]. Journal of Vocational Behavior, 60, 113-172]) for the following content: prestige, effort required, skill required, competition involved, and female and male sex-typing. These content ratings were matched with the theoretical structure of the PGI scales in the first sample (N = 124) and the empirical structure of the PGI items in a second sample (N = 267). Across both approaches, the PGI prestige dimension was highly related to ratings for prestige, effort, skill, effort and skill, and competition, but unrelated to sex-typing. These results support the inclusion of prestige in interest activity assessment and also assist in its interpretation.     

The roles of autonomous motivation and self-control lapses in concurrent adherence to a gluten-free diet and a self-chosen weight loss plan in adults with coeliac disease

Objective: Examine the correspondence between autonomous motivation, self-control lapses, and adherence, to a gluten-free diet (GFD) and weight loss plan in adults with coeliac disease; and assess the impact of the interaction of motivation style and self-control lapses on adherence to both diets.

Design: Cross-sectional survey in 519 adults with coeliac disease, 238 of whom were also attempting weight loss.

Main outcome measures: Adherence, motivation style, frequency of temptation and self-control lapses (e.g. when tired, stressed, happy) for GFD and weight loss plan.

Results: Autonomous motivation was higher, and amotivation lower, for the GFD than weight loss; adherence to the two diets was unrelated. Similar circumstances led to temptation and self-control lapses across diets; both were less frequent for the GFD than weight loss. Motivation and self-control lapses explained 21% and 35% of the variance in adherence, respectively; the interaction between motivation and lapse frequency did not explain additional variance for either diet.

Conclusions: There are clear benefits to developing autonomous motivations and strategies to resist temptation for both the GFD and weight loss. Understanding how these processes differ and interact across diets may lead to the design of interventions to improve adherence and weight outcomes in coeliac disease.