Caregiver Demand and Parent Distress in Juvenile Rheumatic Disease: The Mediating Effect of Parent Attitude Toward Illness

Parents of youth with juvenile rheumatic diseases (JRD) often take on illness management responsibilities that can become burdensome, potentially resulting in poor parent adjustment outcomes. However, not all caregivers will experience increased distress as a result of variability in stress appraisals. The current study examined the role of parent illness attitudes in the relation between perceived caregiver demand and parental distress. Youth (N = 70) ages 7–18 years diagnosed with a JRD and their parents were recruited from a pediatric rheumatology clinic. Parents completed measures of caregiver demand, parental distress, and illness attitudes. Hierarchical regression revealed a relationship between caregiver demand and parental distress. A significant relationship was also found between caregiver demand and parent illness attitudes, as well as parent illness attitudes and parental distress. Thus, parent illness attitudes mediated the relationship between caregiver demand and parental distress. Techniques aimed at altering negative illness attitudes may help parents cope with their caregiving responsibilities.     

A Screening Tool to Assess and Manage Behavioral Risk in the Postoperative Bariatric Surgery Patient: The WATCH

Bariatric surgery is increasingly recognized as a highly effective treatment for individuals who are severely obese. Amount of weight loss and resolution of comorbidities surpass those of nonsurgical approaches; however, suboptimal weight loss and weight regain are not uncommon. These outcomes, though not fully understood, are likely at least partially explained by failure to make long-term behavioral and/or cognitive changes. We are unaware of any established clinical tools to guide providers in assessing postoperative behaviors and identifying those who may require specialized treatment. The goal of this paper is to introduce a brief screening tool, The WATCH, to help clinicians assess and identify patients who may be at risk for poor or untoward outcomes post bariatric surgery. We first review the literature on postoperative outcomes, including weight loss, resolution of comorbidities, suboptimal outcomes, and development of problematic eating behaviors. We then provide an easily-recalled, five-item tool that assesses outcomes, and discuss patient responses that may necessitate further intervention or referral.     

Toward an objective phenomenological vocabulary: how seeing a scarlet red is like hearing a trumpet’s blare

Nagel’s challenge is to devise an objective phenomenological vocabulary that can describe the objective structural similarities between aural and visual perception. My contention is that Charles Sanders Peirce’s little studied and less understood phenomenological vocabulary makes a significant contribution to meeting this challenge. I employ Peirce’s phenomenology to identify the structural isomorphism between seeing a scarlet red and hearing a trumpet’s blare. I begin by distinguishing between the vividness of an experience and the intensity of a quality. I proceed to identify further points of structural isomorphism (a) between the experience of seeing a scarlet red and of hearing a trumpet blare and (b) between the qualities of those experiences. Lastly, I gesture towards how these distinctions can be an aid in describing what it is like to be a bat.     

Author biographies

Philip Pullman has repeatedly drawn attention to his commitment to 'realism' in the writing of his trilogy His Dark Materials. In this paper, which considers Volume 1, and which will be followed by papers on the succeeding volumes, we explore the meaning of this in the domain of psychic reality. We argue that Pullman writes in the tradition of children's literature which explores children's emotional development. His heroine, Lyra, embarks on a journey which involves learning to differentiate between untrustworthy and dependable parental figures. The magical features of the story allow for fluidity in exploring unconscious phantasy and dreamworlds. The 'fantasy' genre of the story allows its author at the same time to explore many aspects of the contemporary world and its problems, and thus offers its readers an experience of intellectual as well as emotional adventure. Philip Pullman machte wiederholt auf seine Verpflichtung an 'Realismus' in seinem Schreiben der Trilogie His dark Materials aufmerksam. In diesem Artikel, der den ersten Band betrachtet und dem weitere Artikel über die folgenden Bände folgen werden, erforschen wir die Bedeutung dieser Ausssage im Bereich der psychischen Realität. Wir argumentieren, dass Pullman in der Tradition der Kinderliteratur schreibt, die die emotionale Entwicklung von Kindern exploriert. Seine Heldin Lyra tritt eine Reise an, die beinhaltet zu lernen, wie man zwischen unzuverlässigen und verlässlichen Elternfiguren unterscheidet. Die magischen Anteile der Geschichte erlauben eine Fluidität, um unbewusste Phantasie und Traumwelten zu explorieren. Das 'Phantasie'genre der Geschichte erlaubt dem Autor, viele Aspekte der zeitgenössischen Welt und ihre Probleme zu explorieren und bietet den Lesern ein Erlebnis sowohl eines intellektuellen wie auch emotionalen Abenteuers. Dans plusieurs passages de sa trilogie À la Croisée des Chemins (His Dark Materials), Philip Pullman attire l'attention de ses lecteurs sur son parti pris de «réalisme». Dans cet article, qui traite du premier tome et qui sera suivi d'autres commentaires sur les tomes restants, les auteurs en explorent la signification pour la réalité psychique; selon eux, les textes de P. Pullman prennent place dans la tradition de la littérature enfantine ayant pour thème le développement émotionnel de l'enfant. Lyra, héroïne du récit, s'embarque pour un voyage qui, pour partie, exige qu'elle apprenne À différencier les figures parentales qui ne sont pas dignes de confiance de celles qui sont autrement plus fiables. Les aspects magiques de l'histoire permettent une certaine fluidité dans l'exploration des phantasmes inconscients et du monde onirique. Puisqu'il s'agit d'un récit «fantastique», le romancier peut s'autoriser À explorer plusieurs aspects du monde contemporain et des problèmes qui s'y manifestent; ce faisant, il propose À ses lecteurs de vivre une aventure non seulement émotionnelle mais aussi intellectuelle. L'autore ha ripetutamente sottolineato la sua fedelta' al 'realismo' nella stesura della trilogia His dark materials. In questo articolo, che esamina il volume 1, e che sara' seguito da altri articoli sui volumi successivi, gli autori esplorano che cosa questo significhi in termini psichici. Gli autori sostengono che gli scritti di Pullman si collochino nell'ambito della tradizione della letteratura infantile nella quale viene esplorato lo sviluppo emotivo dei bambini. L'eroina del libro, Lyra, intraprende un viaggio nel quale imparera' a distinguere tra figure genitoriali di cui non ci si puo' fidare e altre da cui si puo' dipendere. Le caratteristiche magiche del romanzo danno fluidita' all'esplorazione delle fantasie inconscie e del mondo dei sogni. Allo stesso tempo, il genere 'fantastico' della storia da' la possibilita' all'autore di esplorare molti degli aspetti del mondo contemporaneo e dei suoi problemi, dando quindi al lettore la possibilita' di un'esperienza intellettuale oltre che di un'avventura emotiva.     

A Community’s Response to Suicide Through Public Art: Stakeholder Perspectives from the Finding the Light Within Project

Suicide is a preventable public health problem and a leading cause of death in the United States. Despite recognized need for community-based strategies for suicide prevention, most suicide prevention programs focus on individual-level change. This article presents seven first person accounts of Finding the Light Within, a community mobilization initiative to reduce the stigma associated with suicide through public arts participation that took place in Philadelphia, Pennsylvania from 2011 through 2012. The stigma associated with suicide is a major challenge to suicide prevention, erecting social barriers to effective prevention and treatment and enhancing risk factors for people struggling with suicidal ideation and recovery after losing a loved one to suicide. This project engaged a large and diverse audience and built a new community around suicide prevention through participatory public art, including community design and production of a large public mural about suicide, storytelling and art workshops, and a storytelling website. We present this project as a model for how arts participation can address suicide on multiple fronts—from raising awareness and reducing stigma, to promoting community recovery, to providing healing for people and communities in need.     

Self-determination at work: Understanding the role of leader-member exchange

Integrating self-determination theory (SDT) and leader-member exchange (LMX) theory, we explore the role of the leader in facilitating employee self-determination. We test a model of the linkages between employees’ leader-member exchanges, psychological need satisfaction (i.e., satisfaction of autonomy, competence, and relatedness needs), autonomous motivation, and attitudinal outcomes. We posit that high-quality leader-member exchanges facilitate satisfaction of employees’ fundamental psychological needs, which, in turn, enhance autonomous motivation and outcomes. Results for 283 working professionals supported this notion. Structural equation modeling indicated that the employee’s perception of the quality of the LMX was positively related to satisfaction of the needs for competence, autonomy, and relatedness. Satisfaction of competence and autonomy needs was positively related to autonomous motivation, which, in turn, was associated with higher levels of job satisfaction, affective organizational commitment, and subjective vitality. Our findings accentuate the role of leader-employee relationships in creating self-determination at work, and reinforce the importance of self-determination for employee attitudes and well-being. Limitations, implications, and directions for future research are discussed.     

Developmental Trajectories of Maternal and Paternal Attachment and Delinquency in Adolescence

The present study sought to address two research questions: (1) Are there distinct trajectories of maternal and paternal attachment among adolescents? And if so, (2) How do these trajectories of maternal and paternal attachment relate to delinquent trajectories over the ages of 12 to 16? Using a subsample (n = 383) of the longitudinal Gang Resistance Education and Training (GREAT) data, the results from semi-parametric group-based modeling (SPGM) suggested five groups of maternal attachment, where one trajectory exhibited little to no maternal attachment; another group appeared to have an initially low rate of maternal attachment but increased rather noticeably over time; a third trajectory demonstrated high initial levels of maternal attachment but a general decline over time; and the last two groups exhibited high and rather stable rates of maternal attachment, although one of these groups showed evidence of a decline. Comparatively, the same number of trajectory groups was estimated for paternal attachment, with relatively similar patterns over time as for the maternal attachment trajectories, with the exception of one trajectory that appeared to decline initially before demonstrating a substantial increase. Finally, the results from the joint trajectory analysis indicated that as maternal and paternal attachment increased the likelihood for delinquency decreased. Implications for future research and policy are also discussed.     

Psychoanalytic Explorations in Art by Ernst Kris

A review of 43 controlled studies was conducted which evaluated the effectiveness of group therapy for schizophrenics. Group therapy was judged to be an effective modality of treatment for schizophrenics in 67 percent of the inpatient studies. It was especially useful in groups lasting more than three months. Therapy groups were effective for schizophrenics in 80 percent of the outpatient studies. Interaction-oriented approaches were more effective than insight-oriented approaches, which were found to be harmful for some schizophrenics.