Improving Predictions of Condom Behavioral Intentions With Partner-Specific Measures of Risk Perception

Inconsistent findings regarding the predictive validity of perceptions of risk for a sexually transmitted disease (STD) and HIV may be related to the use of nonspecific measures. The objective of this study was to determine whether more specific measures of perceptions of risk for SI Ds and HIV are associated with intentions to use a condom. We interviewed 490 male and female adolescents, 14 to 19 years old, from a free municipal STD clinic. Controlling for whether a condom was used at last sex, the association between perceptions of risk for an STD and HIV with a casual sex partner and intentions to use a condom with a casual sex partner was significant (β_HIV= 14, p < .01, and β_STD=.20, p < .01), as was the association between perceptions of risk for an STD and HIV with a main sex partner and intentions to use a condom with a main sex partner (β_HIV= .31, p <.001, and β_STD= .32, p < .001). This supports the continued inclusion of this construct in models of sexual and other health-related behaviors.     

Grey Matter: Ambiguities and Complexities of Ethics in Research

Ethical dilemmas are often not discussed in the dissemination of educational research. While the ethical guidelines for research seem clear at first glance, a closer look at the intimate nature of qualitative research reveals that there are many ambiguities or ‘grey’ areas where researchers must rely on their personal value systems. This article discusses the challenges faced by an experienced educator, although novice researcher, in considering the ethical parameters of her own research with adolescents with hearing loss. In particular, the grey ethical areas identified by the researcher include: (a) vulnerable population; (b) researcher role confusion; (c) consent; (d) privacy, confidentiality, and anonymity; as well as (e) the nature of risk. Based on the author’s own reflections on beginning the research process, the article presents possible pitfalls and ways of overcoming the possibility of becoming immobilized by the ethical enigmas of research.     

The authoritativeness of mystical experience: An innovative proposal from William James

International Journal for Philosophy of Religion -     

Anxiety sensitivity and posttraumatic stress among traumatic event-exposed youth

Total and factor scores of the Childhood Anxiety Sensitivity Index (CASI) were examined in relation to posttraumatic stress symptom levels within a community-based sample of 68 (43 females) traumatic event-exposed youth between the ages of 10 and 17 years (M_age=14.74 years). Findings were consistent with hypotheses; global anxiety sensitivity (AS) levels, as well as disease, unsteady, and mental incapacitation concerns, related positively to posttraumatic stress levels, whereas social concerns were unrelated to symptom levels. These results suggest that fears of the physical and mental consequences of anxiety are associated with relatively higher levels of posttraumatic stress subsequent to traumatic event exposure. Findings are discussed in terms of potential implications for the role of AS in developmentally sensitive etiological models of posttraumatic stress disorder (PTSD).     

An exploration of lived religion in same-sex couples from Judeo-Christian traditions

Religious involvement has been found to be associated with higher levels of commitment and relationship satisfaction among heterosexually married individuals (Mahoney et al., 1999). Little is known, however, about the religiosity of gay, lesbian, bisexual (GLB) individuals, and virtually nothing is known about religious involvement in same-sex couples. The purpose of this qualitative interview study was to examine couples' experiences of incorporating religious involvement into their committed relationships. In a sample of 14 same-sex couples, we found that couples used their spiritual/religious values to understand and undergird their relationships. In this process, they negotiated intra-couple differences in religious practices, involved themselves in activities that have religious or spiritual meaning to them, created religious social support for their relationships, and experienced some non-supportive or rejecting interpersonal interactions with religious family members, congregants, and strangers. These findings are instructive to therapists who work with same-sex couples and the family members of GLB individuals. We conclude with specific suggestions for practitioners.     

Hot flashes and panic attacks: a comparison of symptomatology, neurobiology, treatment, and a role for cognition

Despite decades of research, the causal mechanisms of hot flashes are not adequately understood, and a biopsychosocial perspective on hot flashes remains underdeveloped. This article explores overlooked parallels between hot flashes and panic attacks within 5 areas: course and symptomatology, physiological indicators, neurocircuitry and biochemical mechanisms, pharmacotherapy, and psychological treatment, noting both similarities and important differences between the 2 events. An integrative conceptual model is presented that identifies key ways in which psychological factors may influence the experience of hot flashes, with clinical implications and areas of future research. This model yields readily testable hypotheses and may provide a template for exploring the role of cognition in the frequency and severity of hot flashes and, in turn, a basis for the development of nonpharmacological treatments.     

Similarities and differences in mothers' and observers' ratings of infant security on the Attachment Q-Sort

This study examined the similarities and differences in maternal and observer Attachment Behavior Q-Sort ratings (AQS; Waters, 1995) and their relations to dimensions of the developmental ecology - maternal sensitivity, infant irritability, parental stress and psychosocial risk. Data was gathered from low risk (adult mothers; N=44) and high risk mother-infant dyads (adolescent mothers; N=83) when infants were aged 6, 10 and 15 months old, attachment being assessed at 15 months by both mothers and independent observers. A common factor was extracted from both sorts and served to operationalize the similarities between mother and observer ratings. Regressions were conducted to extract maternal and observer AQS scores that were unrelated to each other to represent the difference between the two sorts. Correlation analyses indicated that the common AQS factor was moderately linked to maternal sensitivity and parental stress, and showed a weak association to psychosocial risk and infant irritability. Residual maternal scores showed greater correlations with infant irritability and parental stress than did observer residual scores. Observer scores showed a greater correlation with psychosocial risk than maternal scores. Results suggest that common AQS variance presents a pattern of associations with ecological variables that is coherent with attachment research. Variance related to irritability, stress and risk appear to drive the differences between maternal and observer observations.     

Kosteneffektivität ambulanter Psychotherapie

Background

There is a lack of cost-effectiveness analyses (CEA) of psychotherapeutic treatments.

Material and methods

Cost-effectiveness analysis was applied to a sub-sample of 122 psychotherapy outpatients who participated in a large longitudinal study on outpatient psychotherapy (TRANS-OP study). Participants received either psychodynamic psychotherapy (PD, n=69) or cognitive behavioral therapy (CBT, n=53). Effectiveness (change in symptomatic impairment over 2 years) was assessed via the German version of the Outcome Questionnaire (OQ-45.2). Direct health care costs during a 2-year period (psychotherapy and other health care utilizations) were obtained from health insurance claims. Cost-effectiveness analysis methods included incremental cost-effectiveness ratios (ICER) and the net benefit regression approach.

Results

Cost-effectiveness analyses showed no significant differences between the two treatments, neither head-to-head, nor with regard to advantages in certain subgroups of psychotherapy outpatients. A slight dominance of CBT in costs was not maintained after controlling for covariates.

Conclusion

Provided that pivotal covariates such as treatment need are taken into account, cost-effectiveness analyses can contribute to a more equitable distribution of psychotherapeutic resources.     

Testicular Cancer and Genetics Knowledge Among Familial Testicular Cancer Family Members

Purpose  

It was our aim to determine baseline levels of testicular cancer and genetics knowledge among members of families with Familial Testicular Cancer (FTC).     

What Patients and Their Relatives Think About Testing for BMPR2

Clinical genetic testing is available for mutations in BMPR2 associated with pulmonary arterial hypertension (PAH). The aim of this study is to assess attitudes of individuals affected by or at risk for PAH regarding genetic testing. Structured telephone interviews were conducted with 119 individuals affected by or at risk for PAH recruited from pulmonary hypertension clinic at Vanderbilt, Vanderbilt familial PAH registry, attendees at 2006 PHA meeting, and a local PAH support group. Sixty-four percent reported knowing little or nothing about BMPR2 testing. Predictors of greater self-assessed knowledge included having an affected family member and learning about BMPR2 testing through the internet. Most respondents reported that while they spent some time thinking about being tested for BMPR2, they had little trouble deciding. The most frequently cited reason for testing was to provide information for their children. About 20% said they had been tested, even though <5% have actually received clinical testing. Although patients with PAH and their at-risk relatives typically feel relatively uninformed about testing for mutations in BMPR2 and at times are confused about their testing status, they nonetheless report that it is easy to decide about testing.